Effective July 1, 2023, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey, and AmeriHealth Administrators will update their medical policy on injectable dermal fillers for cosmetic procedures for Commercial members.

The coverage position of medical necessity of Radiesse^® for the treatment of unilateral vocal cord paralysis will be removed. This is because the product is no longer being marketed and instructed for use by the manufacturer and the U.S. Food and Drug Administration (FDA) for this indication. It is now only instructed and marketed for use as a product for moderate-to-severe lower face wrinkles and volume loss in the hands. As these are both considered to be cosmetic services, they are not covered.

The following code will also be added: Q4112 Cymetra™, injectable and 1cc

For more information, please view #05.00.62i: Injectable Dermal Fillers for Cosmetic Procedures, which was published as a notification on March 31, 2023.