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PAYER POLICY CHANGES

J1655 Insurance Policy Changes

HCPCS J1655 is officially defined as "Injection, tinzaparin sodium, 1000 iu." HCPCS J1655 is referenced in 1 tracked payer policy change from Missouri Medicaid (MO HealthNet). For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS J1655 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 rules8
Payers requiring prior auth8
  • Ambetter · Effective December 31, 2025

    Prior authorization required

    Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements

  • Arizona Complete Health · Effective December 31, 2025

    Prior authorization required

    Arizona Complete Health CMS-0057-F prior authorization requirements

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for J1655?

Ambetter lists J1655 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does AmeriHealth Caritas require prior authorization for J1655?

AmeriHealth Caritas lists J1655 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for J1655?

Arizona Complete Health lists J1655 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for J1655?

CalViva Health lists J1655 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Centene require prior authorization for J1655?

Centene lists J1655 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.

What insurance policy changes affect HCPCS J1655?

There are 1 tracked policy change affecting HCPCS J1655, including updates from Missouri Medicaid (MO HealthNet). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS J1655?

Payers that have issued tracked updates for HCPCS J1655 include: Missouri Medicaid (MO HealthNet).

How do I get notified when HCPCS J1655 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS J1655. 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 J1655?

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 J1655

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for J1655 in one place.

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