What insurance policy changes affect HCPCS J3391?

There are 10 tracked policy changes affecting HCPCS J3391, including updates from Kansas Medicaid (KanCare), Michigan Medicaid - MDHHS, Blue Cross Blue Shield of Rhode Island. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS J3391?

Payers that have issued tracked updates for HCPCS J3391 include: Kansas Medicaid (KanCare), Michigan Medicaid - MDHHS, Blue Cross Blue Shield of Rhode Island, Anthem BCBS, UnitedHealthcare, Humana.

How do I get notified when HCPCS J3391 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS J3391. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for HCPCS J3391?

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.

J3391 — Injection, atidarsagene autotemcel, per treatment: Insurance Policy Changes

J3391 Insurance Policy Changes

HCPCS J3391 is officially defined as "Injection, atidarsagene autotemcel, per treatment." HCPCS J3391 is referenced in 10 tracked payer policy changes from Kansas Medicaid (KanCare), Michigan Medicaid - MDHHS, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS J3391 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

[California] Precertification/prior authorization requirement changes

Anthem BCBS·Effective Apr 1, 2026

Effective April 1, 2026, Anthem Medicare Advantage plans in California will require prior authorization for 13 newly designated procedures and tests, including respiratory pathogen panels (CPT 0556U, 0563U, 0564U), totally implantable hearing implants (CPT 0951T-0955T), submucosal cryolysis therapy (CPT 0978T-0980T), gait modulation systems (HCPCS E3200), and atidarsagene autotemcel injection (HCPCS J3391). Claims submitted without prior authorization for these codes will be denied.

J3391 Insurance Policy Changes

KMAP BULLETIN: HCPCS Codes Update – July 2025

MMP 25-26: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Additional HCPCS Level II Code Changes and Modifier Changes

[New York] Precertification/prior authorization requirement changes

[California] Precertification/prior authorization requirement changes

[Ohio] Precertification/prior authorization requirement changes

[Virginia] Prior authorization requirement changes

[Virginia] Precertification/prior authorization requirement changes

North Carolina Medicaid: Prior authorization updates for specialty pharmacy medications

Lenmeldy (atidarsagene autotemcel) - Medicare Advantage (Revised)