Spasticity is a common medical condition treated by Physiatrists of all sub-specialties. It is not uncommon for pediatric, spinal cord injury, brain injury, and pain medicine specialists to be responsible for the treatment of spasticity. One of the hallmarks of spasticity therapy is botulinum toxin chemodenervation. Our session proposal aim is to elucidate various practice paradigms for the management and treatment of spasticity with botulinum toxins. We will also present successful practice habits in multiple settings (inpatient, outpatient, VA, pediatric facilities) that will improve outcomes and optimize reimbursement. The session will focus on common and difficult scenarios in our case-driven session.