Treatment of chronic migraine and chronic tension-type headache

OnabotulinumtoxinA (onaBoNT-A, Botox) is a type of botulinum toxins used for the treatment of chronic migraine. A variety of non-pharmacological interventions are also used for the treatment of chronic migraine and headaches. The effectiveness of these non-pharmacological interventions, however, is not well established.

Coverage decision: OnabotulinumtoxinA and other selected treatments (Effective date: December 1, 2017; Revision date: October 1, 2018*)

Authorization requirements

Is authorization required? How do I get pre-authorization?
Yes

L&I (State fund):
Complete the prior authorization form and fax to: 360-902-9170.

Self-insured:
Contact the employer or its third party administrator


Regulatory authority and related information

* The effective date of the revised decision is retroactive to the origianl effective date of 12/1/17.

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