Скачать или смотреть HOPDs & Physicians: Prepare for Critical LCD Changes that Affect Botox Prior Authorization

This is the recording of a live event hosted on 1/22/2026.

If your hospital outpatient department (HOPD) or practice provides Botox services that are subject to Medicare’s prior authorization (PA) process, this is a must-view video. Significant changes are coming that could directly impact your Botox claims, and it’s crucial to be prepared.

What’s at stake?
The Local Coverage Determination (LCD) L39909 for Botulinum Toxin Injections will be released on January 8, 2026, with an effective date of February 22, 2026. These changes will impact prior authorization (PA) requests for specific CPT codes 64612 and 64615 in the hospital outpatient department (HOPD) of Prospective Payment System (PPS) hospitals.

Why listen?
This webinar will provide an in-depth analysis of the upcoming LCD updates, focusing on how these changes will specifically affect the HOPD PA process. As this new guidance could significantly alter how Botox services are approved and reimbursed, staying ahead of these regulatory shifts is essential to ensure continued compliance and avoid claim denials.

Resources
Local Coverage Determination L39909 Botulinum Toxin Injections: https://www.cms.gov/medicare-coverage...
Billing and Coding: Botulinum Toxin Injections: https://www.cms.gov/medicare-coverage...
Prior Authorization for Hospital Outpatient Department Services (HOPD) Overview: https://www.wpsgha.com/guides-resourc...

Chapters:
00:00 Introduction
01:17 Objective and Agenda
02:28 What Has Changed
03:30 Coverage
07:26 Prior Authorization of Botulinum Toxin
08:07 Documentation
11:16 Blepharospasms Documentation
18:50 Cervical Dystonia (Spasmodic Torticollis) Documentation
19:40 Migraines Documentation
29:08 Hemifacial Spasm/Facial Dystonia Documentation
33:36 Recap
34:27 Questions and Answers
1:23:43 Closing Remarks