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AAPM&R Advocacy Win! Medicare Contractors Finalize Comprehensive Botulinum Toxin Policy Aligned with Academy Advocacy Efforts and Valuable Member Input

Jan 27, 2026
Early this month, several Medicare Administrative Contractors (MACs) released final local coverage determinations (LCDs) and related billing and coding articles for botulinum toxin injections. These final policies come after more than a year of strategic AAPM&R advocacy and collaboration with the MACs to help maintain coverage for spasticity and dystonia. We are pleased to share that the final policies largely align with the requests the Academy made in our comments to and advocacy discussions with the MACs.

 

Your Academy is grateful for the advocacy of our many members who engaged in the comment process via our letter-writing campaign on these LCDs. We’d like to highlight several members who helped draft our Academy comments and worked collaboratively with leadership at the MACs to review evidence and discuss the needs of the spasticity patient population. Thank you to John Baratta, MD, MBA, FAAPMR; Zachary Bohart, MD, MS, FAAPMR; Kimberly Heckert, MD, FAAPMR; Christina Kwasnica, MD, FAAPMR; and Lauren Shapiro, MD, MPH, FAAPMR for more than a year of advocacy!

Spasticity remains an ongoing priority for AAPM&R in many areas. We invite members to join the conversation in the Spasticity Community. You can join any community by updating your member profile here. You may also learn about updates here and watch for upcoming information about spasticity-related Expert Conversations in PM&R Practice.

 

“Without the direct educational and advocacy efforts of AAPM&R, these policies to decrease the dose of botulinum toxins we can give our patients surely would have passed. The Academy deserves all of our thanks for mounting such a concerted and well-planned effort, and they’ve gained an involved, active member for life.”

—Zachary W. Bohart, MD, MS, FAAPMR

 

Final policies, which take effect on February 22, 2026, are linked below.

 

CGS

 

NGS

 

Noridian

 

WPS

 

Palmetto

Coding Article: Article – Billing and Coding: Botulinum Toxin Injections (A59714)

As a reminder, members in First Coast and Novitas jurisdictions should review our recent announcement about the botulinum toxin injection LCDs finalized by those MACs. Members with questions can contact Academy staff at healthpolicy@aapmr.org.