Does J1944 require prior authorization?

Yes, J1944 requires prior authorization (medium confidence). Conditional coverage; review criteria to confirm PA need.

What is the Medicare reimbursement rate for J1944?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

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`J1944`, Injection, aripiprazole lauroxil, (aristada), 1 mg

HCPCS/CPT

Prior Authorization

Prior Auth Required

Conditional coverage; review criteria to confirm PA need (medium confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Key Coverage Criteria

Coverage indication: Atypical antipsychotic injections Aristada or Zyprexa Relprevv are covered when all listed criteria are met.

2 Active Policies

HEALTHPARTNERS-CC-ENTRY-203025, Atypical antipsychotic injections (Aristada, and Zyprexa Relprevv) – Minnesota Health Care Programs

MULTI

HEALTHNET_OR-HNOR-ARIPIPRAZOLE-LONG-ACTING-INJECTIONS-ABILIFY-MAINTENA-ABI-A7BEB3FC1A, Aripiprazole Long-Acting Injections (Abilify Maintena, Abilify Asimtufii, Aristada, Aristada Initio); CP.PHAR.290

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J1944, Injection, aripiprazole lauroxil, (aristada), 1 mg