No Longer Doing Botox for Medicare Patients


We love our patients and we love helping them to get well. In this present time of health care in America, it is becoming almost impossible for small independent practices to stay in business. The amount of overhead keeps growing up exponentially due to more and more regulations, labor intensive fighting with insurance companies to get them to pay us for the work we have done, and growing deductibles in insurance policies.  The only way for us to survive and to be here for our patients is to eliminate the many areas in which we are losing money.

One of those areas of financial drain is doing Botox treatments on patients with Medicare.  Presently Medicare pays us a “profit” of $50 for each Botox treatment. However, it takes $60 in average labor cost just to get the prior authorizations and order the Botox. The provider does it for free but uses another $20 of our supplies that we use.  On top of that, Medicare will refuse payment completely for every 10th treatment for reasons that only they know.  We pay out of pocket $1200 for each bottle of Botox and when Medicare refuses to pay us for it, it is a $1200 loss. So, in summary, each time we do a Botox treatment, the provider does it for free (does not charge for his time) but we still loose from $60 to $120 each time.  No business can survive with these kinds of losses.  If we disappear, then no one will get the help they deserve.

We will be happy to continue the Botox treatments if the patient is willing to purchase their own Botox.  We will be happy to supply names of other providers who do Botox for Medicare patients. Most of them would be part of large institutions. Medicare, due to lobbying efforts by large institutions, pay them double what they pay us through what is know as a “facility” payment. Therefore the large institutions can afford to do it.