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PAYER POLICY CHANGES

C9145 Insurance Policy Changes

HCPCS C9145 is officially defined as "Injection, aprepitant, (aponvie), 1 mg." HCPCS C9145 is referenced in 7 tracked payer policy changes from BCBS Michigan, Arkansas Medicaid, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C9145 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • Anthem BCBS · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Medicare)

  • Elevance Health · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Elevance CMS-0057-F list)

  • Centene · Effective December 31, 2025

    Prior authorization required

    Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for C9145?

AmeriHealth Caritas lists C9145 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for C9145?

Anthem BCBS lists C9145 on List of items and services that require prior authorization (Medicare) for medicare advantage plans (list dated February 11, 2026). Verify with the payer before scheduling.

Does Centene require prior authorization for C9145?

Centene lists C9145 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Elevance Health require prior authorization for C9145?

Elevance Health lists C9145 on List of items and services that require prior authorization (Elevance CMS-0057-F list) for medicare advantage plans (list dated February 11, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS C9145?

There are 7 tracked policy changes affecting HCPCS C9145, including updates from BCBS Michigan, Arkansas Medicaid, Texas Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS C9145?

Payers that have issued tracked updates for HCPCS C9145 include: BCBS Michigan, Arkansas Medicaid, Texas Medicaid, Kansas Medicaid (KanCare), Michigan Medicaid - MDHHS.

How do I get notified when HCPCS C9145 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS C9145. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS C9145?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for C9145

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for C9145 in one place.

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