Start free
PAYER POLICY CHANGES

J3401 Insurance Policy Changes

HCPCS J3401 is officially defined as "Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml." HCPCS J3401 is referenced in 4 tracked payer policy changes from Harvard Pilgrim Health Care, Aetna, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS J3401 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Watch J3401

Get one email when a payer policy names J3401, 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 rules19
Payers requiring prior auth19
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Fidelis Care · Effective November 1, 2026

    Prior authorization required

    Fidelis Care Metal-Level Products authorization grid

  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for J3401?

Ambetter lists J3401 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 J3401?

AmeriHealth Caritas lists J3401 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 J3401?

Anthem BCBS lists J3401 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for J3401?

Arizona Complete Health lists J3401 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 BCBS Arizona require prior authorization for J3401?

BCBS Arizona lists J3401 on AZ Blue Standard Prior Authorization Requirements Code List (Updated 10/01/2026) for commercial plans (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS J3401?

There are 4 tracked policy changes affecting HCPCS J3401, including updates from Harvard Pilgrim Health Care, Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS J3401?

Payers that have issued tracked updates for HCPCS J3401 include: Harvard Pilgrim Health Care, Aetna, Blue Cross & Blue Shield of Mississippi, Texas Medicaid.

How do I get notified when HCPCS J3401 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS J3401. 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 J3401?

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 J3401

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for J3401 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