CommercialCoverageLow impact
05.00.62i, Injectable Dermal Fillers for Cosmetic Procedures
Independence Blue Cross·Dermatology, Plastic Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
This is an annual policy reissue with no substantive changes to coverage or billing requirements for Injectable Dermal Fillers for Cosmetic Procedures. The policy continues to classify dermal fillers as cosmetic services (non-covered for most plans) except in cases of post-trauma reconstruction. One HCPCS code (Q4112 for Cymetra) was added to the policy in the 07/01/2023 version, but no new changes have occurred since then.
Action Required
No immediate action required. This is a routine annual reissue with no changes to policy language, coverage criteria, or billing codes since 07/01/2023. Billing team should verify current system configuration aligns with cosmetic service exclusions for injectable dermal fillers (CPT 11950-11954, HCPCS Q2026, Q2028, Q4112, J3590, G0429). Document exception pathway for post-trauma reconstruction cases requiring medical necessity review.