Myobloc® (botulinum toxin type B)

No prior authorization required for:

  • Emergency room
  • Inpatient
  • Skilled nursing facility

For further information, please see the Injectable Drugs page

Code(s): J0587

Benefit: Medical


  • Per 100 units; for treatment of cervical dystonia. See prior authorization form.
  • No authorization needed when billed by neurologists, rehabilitation medicine or physical medicine.

Length of authorization: 1 injection. Injections must be separated by at least 90 days