Billing of botulinum toxin for hyperhidrosis: Ethical considerations

Severe hyperhidrosis has significant effects on a patient's daily life. Billing of botulinum toxin injections for this condition varies among practices, despite most insurance covering its use in patients who fail first-line therapies. Although many dermatologists bill insurance for qualified patients, others charge according to the fee schedule for cosmetic botulinum toxin injections, even if patients have insurance that covers the service.1