Summary
UnitedHealthcare's individual exchange botulinum toxin policy was revised effective November 1, 2026, which has already passed. The policy now applies in Massachusetts and New York, refers Nevada to the UnitedHealthcare Commercial version, and drops several diagnosis requirements for cervical dystonia, chronic anal fissures and detrusor overactivity, while HCPCS J0589 is now clarified for Daxxify and new eye-related ICD-10 codes were added for J0585 and J0586.
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What to do
Action · 6 steps
01Already effective 11/01/2026: Confirm your exchange botulinum toxin billing matches the revised policy.
02Billing team: in charge entry, use HCPCS J0589 for Daxxify, and for J0585 and J0586 add the H49 and H50 diagnosis codes listed in the bulletin to the diagnosis lists.
03Because the cervical dystonia, chronic anal fissure and detrusor overactivity diagnosis requirements were removed for Botox and Dysport, and the cervical dystonia requirement was removed for Daxxify and Xeomin, update the internal documentation checklist your providers use for these drugs.
04Billing team: for Massachusetts and New York claims, note that the policy no longer excludes those states, and for Nevada, use the UnitedHealthcare Commercial policy version as the bulletin directs.
05Tell providers and front desk staff about these changes.
06Because the effective date has passed, check the current policy at the source URL to confirm how it applies to your contracts.
Codes mentioned
J0585J0586J0589H49.00H49.01H49.02H49.03H49.10H49.11H49.12H49.13H49.20H49.21H49.22H49.23H49.30H49.31H49.32H49.33H49.40H49.41H49.42H49.43H49.811H49.812H49.813H50.00H50.011H50.012H50.021H50.022H50.031H50.032H50.041H50.042H50.05H50.06H50.07H50.08H50.10H50.111H50.112H50.121H50.122H50.131H50.132H50.141H50.142H50.15H50.16H50.17H50.18H50.30H50.311H50.312H50.32H50.331H50.332H50.34H50.40H50.411H50.412H50.42H50.43H50.50H50.51H50.52H50.53H50.54H50.55H50.611H50.612H50.621H50.622H50.629H50.631H50.632H50.639H50.641H50.642H50.649H50.651H50.652H50.659H50.661H50.662H50.669H50.671H50.672H50.679H50.681H50.682H50.689H50.811H50.812
Original notice
Botulinum Toxins A and B
uhcprovider.com · Always check the source before changing claims.
Related changes
See all UnitedHealthcare changes →Botulinum Toxins A and BHighEffective Nov 1, 2026 · Medical Benefit Drug PolicyBotulinum Toxins A and BMediumEffective Nov 1, 2026 · Medical Benefit Drug PolicyBotulinum Toxins A and BMediumEffective Nov 1, 2026 · Medical Benefit Drug PolicyBotulinum Toxins A and BHighEffective Nov 1, 2026 · Medical Benefit Drug PolicyBrowse every UnitedHealthcare change in the policy list
Related policy hubs
UnitedHealthcare policiesMA policy changesNY policy changesNV policy changesNeurologyUrologyGastroenterologyOphthalmologyCode J0585Code J0586Code J0589Code H49.00Code H49.01Code H49.02Code H49.03Code H49.10Code H49.11Code H49.12Code H49.13Code H49.20Code H49.21Code H49.22Code H49.23Code H49.30Code H49.31Code H49.32Code H49.33Code H49.40Code H49.41Code H49.42Code H49.43Code H49.811Code H49.812Code H49.813Code H50.00Code H50.011Code H50.012Code H50.021Code H50.022Code H50.031Code H50.032Code H50.041Code H50.042Code H50.05Code H50.06Code H50.07Code H50.08Code H50.10Code H50.111Code H50.112Code H50.121Code H50.122Code H50.131Code H50.132Code H50.141Code H50.142Code H50.15Code H50.16Code H50.17Code H50.18Code H50.30Code H50.311Code H50.312Code H50.32Code H50.331Code H50.332Code H50.34Code H50.40Code H50.411Code H50.412Code H50.42Code H50.43Code H50.50Code H50.51Code H50.52Code H50.53Code H50.54Code H50.55Code H50.611Code H50.612Code H50.621Code H50.622Code H50.629Code H50.631Code H50.632Code H50.639Code H50.641Code H50.642Code H50.649Code H50.651Code H50.652Code H50.659Code H50.661Code H50.662Code H50.669Code H50.671Code H50.672Code H50.679Code H50.681Code H50.682Code H50.689Code H50.811Code H50.812