Skip to Accessibility Menu Skip to Login Skip to Content Skip to Footer

Botox billed as "surgery"?

Am35303n

Hello all,

I have been receiving botox treatments since 2019, and it has proven to be the most effective treatment for my condition. I also use Nurtec as a rescue medication. The two combined together have given me my life back.

My first insurance provider, Emblem Health, billed the botox treatment as a specialist visit--$30 copay. I changed jobs and my new insurance, Horizon Blue Cross Blue Shield, billed the botox treatment as surgery--$150 copay. My neurologist's office confirmed they are using all the same billing codes (64615). I have written to Horizon asking them to appeal and reclassify the charge but have not heard back yet. (We're on day 20 of their 60 day limit). I canceled my last botox appointment because I could not afford another "surgery" copay.

I am about to start a new job and the only insurance they offer is Horizon Blue Cross Blue Shield. I am worried I will have to pay for "surgery" 4 times a year.

Does anyone have any experience with this? Either specifically with Horizon or another insurance company? Any advice?

Thank you in advance!