Start free
PAYER POLICY CHANGES

J0402 Insurance Policy Changes

HCPCS J0402 is officially defined as "Injection, aripiprazole (abilify asimtufii), 1 mg." HCPCS J0402 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS J0402 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Watch J0402

Get one email when a payer policy names J0402, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

No account needed. We send a confirmation link first, and every email has a one-click stop link.

REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • Fidelis Care · Effective November 1, 2026

    Prior authorization required

    Fidelis Care Metal-Level Products authorization grid

  • 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 J0402?

AmeriHealth Caritas lists J0402 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Centene require prior authorization for J0402?

Centene lists J0402 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 Fidelis Care require prior authorization for J0402?

Fidelis Care lists J0402 on Fidelis Care Metal-Level Products authorization grid for exchange plans (list dated November 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS J0402?

There are 1 tracked policy change affecting HCPCS J0402, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS J0402?

Payers that have issued tracked updates for HCPCS J0402 include: Aetna.

How do I get notified when HCPCS J0402 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS J0402. 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 J0402?

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 J0402

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for J0402 in one place.

See every payer rule

RELATED

All billing codesJ3590C9399J3490992159921399202

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alertHow Policy Monitoring works