Tariffs 9731, 9733 and 9735, located on page Q‑4 of the Physician’s Manual, may be claimed by approved physicians who use botulinum toxin injections to treat hyperhidrosis. This tariff was previously restricted to certain specialties but has recently expanded to allow any physician with appropriate training to submit to be authorized to provide this service.

The full tariff descriptions and rules of application are outlined below:

Note:

1. Botulinum toxin injections are indicated in those cases of hyperhidrosis where conservative measures (e.g. aluminium chloride, iontophoresis, or systemic medications) fail to resolve the problem or where the symptoms of hyperhidrosis are severe enough to give rise to emotional and social, as well as functional problems that impact the patient’s quality of life.
2. The treatment shall be administered by a physician approved by the Chief Medical Officer of Shared Health.
3. The treatment includes pre-injection assessment, nerve blocks/​local anesthetic, subsequent visits and any further injections within 12 (twelve) weeks.

Billing Notes

The fee includes:

• Any nerve blocks or local anesthetic administered in conjunction with the treatment;
• All injections for the treatment of hyperhidrosis for the bilateral region on the day of the service;
• Any subsequent injections for the treatment of the bilateral region provided within twelve weeks of the initial series of injections; and
• The pre-injection assessment and any subsequent visits to assess the treatment within twelve weeks of the initial series of injections.

Treatment for more than one region: If more than one region (axillary, palmar or plantar) is being treated at the same visit or within twelve weeks of the initial treatment, the full fee is claimable for each tariff.

Example 1: A physician provides a series of injections to treat axillary hyperhidrosis but only completed one side due to the patient’s tolerance. The patient returns to have additional injections on the other side four weeks later. 

In that case, Tariff 9731 may be claimed only once for the initial side and may not be claimed again for the second side.

Example 2: A patient receives a series of bilateral injections for the treatment of palmar hyperhidrosis. Eight weeks later the same patient receives a series of bilateral injections for the treatment of plantar hyperhidrosis. 

In this case, both Tariff 9733 and Tariff 9735 may be claimed in full.