Traditional MedicarePrior AuthMedium impact
Authorization Updates Changes - October 1, 2026
Sentara Health Plans·VA · Psychiatry·Prior Authorization
Effective date
Oct 1, 2026
We identified it
Oct 8, 2026
Summary
Effective October 1, 2026, prior authorization is no longer required for HCPCS codes J1943 (Aripiprazole Lauroxil Aristada Initio) and J1944 (Aripiprazole Lauroxil Aristada) when billing all Medicare products in Virginia. Providers should remove authorization requirements from their workflows for these codes.
Action Required
Already effective as of October 1, 2026: Billing team should verify that the practice has removed prior authorization requirements for codes J1943 and J1944 in the billing system for all Medicare products in Virginia and confirm current applicability. Update internal policies and staff training to reflect that these codes no longer require authorization, reducing claim processing delays for these injectable medications.