Botulinum Toxin Injections — Therapeutic
Tariffs 9757, 9758 and 9766, located on page Q‑4 of the Physician’s Manual, may be claimed by any physician who uses botulinum toxin injections to treat the specific disorders outlined below.
| 9757 | Series of bilateral intramuscular injections of Botulinum Toxin for control of blepharospasms, including pre-injection assessment, any necessary EMG control, subsequent visits and any further injections within six weeks |
| 9758 | Series of intramuscular injections of Botulinum Toxin for control of hemifacial spasms, including pre-injection assessment, any necessary EMG control, subsequent visits and any further injections within six weeks |
| 9766 | Series of unilateral or bilateral intramuscular injections of Botulinum Toxin for control of spasmodic torticollis, focal spasticity, focal painful dystonia and strabismus, and spasmodic dysphonia including any EMG control, subsequent visits and any further injections within six weeks |
Restrictions apply to certain approved specialists for tariffs for botulinum toxin injections for the treatment of hyperhidrosis. For more information on billing these tariffs, please see Botulinum Toxin Injections for Hyperhidrosis.
Billing Notes
The fee for Tariff 9757, 9758 or 9766 includes:
- EMG control;
- All initial injections for the treatment of the specific disorder;
- Any subsequent injections for the treatment of the specific disorder provided within six weeks of the initial injections; and
- Any subsequent visits to assess the specific disorder within six weeks of the initial series of injections.
Only where exceptional circumstances are present may a second claim within six weeks of the initial treatment be made. Make such a claim on a By Report basis.
Treatment for more than one disorder — Different Tariffs: If more than one disorder corresponding to different tariffs are being treated at the same visit or within six weeks of the initial treatment, the full fee is claimable for each tariff.
Treatment of more than one disorder – Tariff 9766: If more than one disorder listed under Tariff 9766 is being treated at the same visit or within six weeks of the initial treatment, it is Manitoba Health’s policy Tariff 9766 is payable only once.
Example 1: The practitioner treats hemifacial spasms with a series of injections (Tariff 9758). Then, on the same day or within six weeks of this service, a series of injections is also given to treat spasmodic torticollis (Tariff 9766).
In that case, both Tariff 9758 and 9766 may be claimed in full.
Example 2: A patient receives a series of injections for focal spasticity (Tariff 9766), and four weeks later, the same patient receives a series of injections for spasmodic torticollis (Tariff 9766).
In that case, claim Tariff 9766 only once for the initial treatment. Subsequent injections for the same or another disorder listed under Tariff 9766 within the six-week period can only be claimed under exceptional circumstances By Report.
Complete and regional visit fees: Do not claim a complete or regional visit fee for pre-injection assessment in addition to Tariff 9757 or Tariff 9758. However, visit fees may be claimed for pre-injection assessments in respect of Tariff 9766.