Traditional MedicareCoverageMedium impact
Botulinum Toxin Injections
Medicare/CMS - LCD·Neurology, Dermatology, Plastic Surgery +2 more·Local Coverage Determination
Effective date
Apr 2, 2026
We identified it
Jun 17, 2026
Summary
This is a Local Coverage Determination for Botulinum Toxin Injections from WPS Insurance Corporation (Medicare Administrative Contractor) that will be effective April 2, 2026. The policy establishes coverage criteria and billing guidelines for botulinum toxin procedures under Medicare.
Action Required
By April 2, 2026: Billing team must review the full LCD L39909 policy text to identify specific coverage criteria, prior authorization requirements, and documentation standards for botulinum toxin injections. Update billing workflows and encounter forms to ensure compliance with WPS Medicare coverage requirements. Monitor for claim denials if coverage criteria are not met.