In April, five Medicare Administrative Contractors (MACs), Noridian, WPS, NGS, Palmetto, and CGS 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.
Noridian, WPS, NGS and Palmetto are accepting comments on the draft LCDs through May 15, and CGS is accepting comments on their draft through June 6. 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, Palmetto and CGS 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
CGS DL39857 Proposed Botulinum Toxin Injection LCD
In addition to ongoing advocacy directly with the MACs, AAPM&R is also pursuing LCD process reform through a variety of channels. AAPM&R is currently seeking support on these efforts from the entire house of medicine and has recently submitted a resolution for consideration at the Annual Meeting of the AMA House of Delegates taking place in June. AAPM&R also participates on a Carrier Advisory Committee Coalition. Members with questions about the proposed LCDs or our ongoing advocacy efforts can contact the Academy at healthpolicy@aapmr.org.