On April 2, four Medicare Administrative Contractors (MACs), Noridian, WPS, NGS, and Palmetto, released new draft local coverage determinations (LCDs) for botulinum toxin injections. These draft LCDs follow implementing of new botulinum toxin injection LCDs from these MACs as well as CGS on February 22 of this year. AAPM&R is still working to analyze the differences between the recently implemented policies and the new drafts.
Noridian, WPS, NGS, and Palmetto are accepting comments on the draft LCDs through May 15, 2026. Your Academy will submit comments by the May deadline consistent with our previous advocacy on botulinum toxin injections for spasticity. Members in jurisdictions operated by Noridian, WPS, NGS, and Palmetto should review the policy for their jurisdiction and consider submitting comments:
Noridian DL35172 Proposed Botulinum Toxin Injection LCD
NGS DL39832 Proposed Botulinum Toxin Injection LCD
WPS DL39909 Proposed Botulinum Toxin Injection LCD
Palmetto DL39836 Proposed Botulinum Toxin Injection LCD
Members with questions about the proposed LCDs can contact the Academy at healthpolicy@aapmr.org.