The therapeutic use of Botox (Onabotulinum Toxin A) is quickly becoming recognized as part of the management of facial pain, TMD and muscle hypertrophy. Provinces vary in terms of the scope of the dentist in administering Botox, so make sure to investigate the limitations of your province and keep within your licensing. Here we will present the administrative side of being a Therapeutic Botox provider.
Billing
There are a number of potential codes that can be used for billing under the fee guide. I have found that approximately 20% of my patients are covered, so I set the expectation that it is likely to be out of pocket. The fee that you allocation under the injection code can be adjusted based on your time and the extent of treatment (Often practitioners will aim for $10-12 per unit). The average pricing I have seen is $250-1000 for the injection fee.
78601 Β Β Injection, Therpeutic Drug + E
OR
96201 Β Β Intramuscular Drug Injection +E
AND
99555 Β Β Botox cost (DINΒ 01981501), $357 per 100 units (2022 pricing on AbbVie)
Ordering
Regarding ordering,Β there are two options:
1. ClinicΒ orders it from Abbvie/Allergan directly.
2. Clinic writes a prescription forΒ Onabotulinum Toxin A and patient gets itΒ from the pharmacy – may be coveredΒ under a drug plan. The botox will costΒ a little more as there isΒ a dispensing fee. Botox must beΒ stored cold, so I recommend if you doΒ this method to advise the patient to bring a coldΒ container.
Storage
Botox comes as a powder that needs to be reconstituted with saline. Prior to reconstitution, it should be stored in a freezer. After reconstitution it can be stored in a fridge for up to 3 weeks.
Supplies list
- Botox – ordered via AbbVie
- Saline – Bacteriostatic Sodium Chloride Injection USP 0.9% 10ml (DIN 00037818), not stored in fridge
- Insulin Syringe
- Needle for reconstitution, 18G
- Needle for injection, 30G
- Alcohol Wipe for skin
- Gauze
- Markers for injection sites
Where to order: pharmacy, medical catalog e.g. Medline
