Who we serve · Aesthetics practices
Medical care inside an aesthetics practice. Billed as medicine when the record says it is.
An aesthetics practice under a medical director often delivers treatments a payer covers, and bills all of them as cash because nothing was set up for insurance. We sort the medical work from the cosmetic, enroll the medical director and the practice, and bill what is payable.
Summary
Is Botox for excessive sweating covered by insurance?
Sometimes. Botulinum toxin for hyperhidrosis is a procedure on the sweat glands, billed under CPT 64650 or 64653, or the unlisted code 64999 for hands and feet, and a payer covers it when the sweating meets its medical criteria and the chart shows it. Treated as elective, it is cash-pay. Several other services sold in aesthetic settings carry the same split between covered and cosmetic.
A payer pays for a diagnosis.
The same injection can be a cosmetic sale for one patient and covered care for the next. Botulinum toxin for excessive sweating is a procedure on the sweat glands, and Medicare's billing article for it lists CPT 64650 and 64653. Whether a plan covers it, and what it wants in the chart first, is written in that plan's own policy.
Some services split in two. The medical visit pays, and the product that follows may not. Medical weight management is the clearest case: most large employers leave GLP-1 drugs for weight loss off their plans, while the visits and counseling bill against a documented diagnosis.
None of it pays without enrollment. The medical director has to be on file with each plan, linked to the practice, before the first claim. So does any nurse practitioner or physician assistant treating under that direction.
A written answer first, then enrollment and billing.
- The answer
- For one service at a time, a written answer on whether your payers cover it, under which codes and diagnoses, and what the chart must show. That is the Service Line Made Billable.
- Enrollment
- The practice and the medical director, and each treating clinician, with the plans the answer points to.
- Billing
- Covered services billed to each plan's policy, followed until paid, with every denial traced and worked.
| Piece of work | Fee |
|---|---|
| Service Line Made Billable, one service, one written answer | $2,500 |
| The practice's application with one plan | $450 |
| One clinician's application with one plan | $350 |
| Billing the covered work | By agreement |
Common questions from aesthetics practices.
We are cash-only today. Is insurance worth adding?
For some services, yes, and for many, no. The written answer tells you which, plan by plan, before you spend on enrollment. A no in writing is worth having too.
Does our medical director need to be enrolled?
Yes, with each plan you bill, and linked to the practice. So does any clinician whose name goes on a claim.
Will you help us bill a cosmetic treatment as medical?
No. If the diagnosis and the record do not support it, the claim does not go.
Name the service you think a plan should pay for.
We tell you what it would take, in writing. The billing review starts from report totals.
Say which clinician performs the service and what license they hold.