Fee Navigator®

    Health Service Code 13.59K

    Injection of Botulinum A Toxin

    For treatment of spasticity due to upper motor neuron injury or disease

    1. Single benefit applies regardless of the number of injections or limbs injected.
    2. May only be claimed for purposes such as improving gait, reduction of pain, improving upper limb function.
    3. May be claimed for initial and follow-up or repeat injections at a later date.
    4. May not be claimed with 07.09A or 07.09B.
    Common terms:
    • Botox
    Category:M Minor Procedure
    Base rate:$162.38

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    ROLEANEYesReplace Base$111.49
    ROLEANESTYesReplace Base$18.55
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.55
    TRAYMINTIncrease By$13.11
    LVPLVP75YesReduce Base To75%

    Governing Rules: