OnabotulinumtoxinA (Botox) is a neuromuscular blocking agent and acetylcholine release inhibitor indicated for multiple neurologic, urologic, dermatologic, ophthalmologic and gastrointestinal conditions. The policy defines medical necessity criteria aligning FDA-approved uses with Centene-specific initial and continuation requirements and dose limits. Coverage stance: covered_with_criteria — Botox is authorized when indication-specific criteria (including prescriber specialty, age limits, prior therapy where required, documentation of treatment plan and unit limits, and intervals since prior botulinum toxin) are met. The scope applies across Commercial, HIM and Medicaid lines of business and includes FDA-approved indications plus select off-label uses with supporting evidence requirements.