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Updated July 1st, 2026

ABILIFY MAINTENA J Code: J0401

Injection, aripiprazole (abilify maintena), 1 mg

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Q4 2026 Medicare Payment Limit for J0401, effective October 1, 2026: $7.456 per HCPCS billing unit, down 0.1% from $7.462. From CMS's final file.

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Medicare Payment Limit ?
$7.462
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$7.462
/ HCPCS billing unit · APC 1468
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
8
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Drug & Product Overview

HCPCS Descriptor Injection, aripiprazole (abilify maintena), 1 mg
HCPCS Added Date January 1, 2014
Manufacturer Otsuka America Pharmaceuticals Inc
Route of Administration Intramuscular
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Kit

About ABILIFY MAINTENA

Abilify Maintena is a medication aligned to the HCPCS J Code: J0401 for billing, pricing, and reimbursement purposes in the United States. Classified under Psychiatric, it is administered via the intramuscular route and manufactured by Otsuka America Pharmaceuticals Inc.

According to CMS Drug Use Information: This medication is used to treat a certain mental/mood disorder (schizophrenia). Some brands of this medication are also used to treat bipolar disorder. Extended-release aripiprazole injection is a long-acting form of aripiprazole. Aripiprazole belongs to a class of drugs known as atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 5 of 8 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
59148-0018-71 Abilify Maintena Otsuka America Pharmaceuticals Inc. 300 300 MG
59148-0019-71 Abilify Maintena Otsuka America Pharmaceuticals Inc. 400 400 MG
59148-0045-80 Abilify Maintena Otsuka America Pharmaceutical, Inc. 300 Kit
59148-0072-80 Abilify Maintena Otsuka America Pharmaceutical, Inc. 400 Kit
59148-0232-12 Abilify Maintena Otsuka America Pharmaceutical, Inc. 300 Kit
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ABILIFY MAINTENA
ABILIFY MAINTENA
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ABILIFY MAINTENA Pricing & Reimbursement

J0401 Private Payer Reimbursement
$7.21 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

ABILIFY MAINTENA CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
JW / JZ modifiers apply

CMS has identified Abilify Maintena (J0401) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ABILIFY MAINTENA Medically Unlikely Edits (MUE)

The most billing units of J0401 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
400 units / day
= 400 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

ABILIFY MAINTENA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Bipolar I Disorder Schizophrenia

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Frequently Asked Questions

Is there an available Abilify Maintena billing and coding guide?
Our team has not identified a manufacturer-published source of billing and coding information for ABILIFY MAINTENA.
Are there any available Abilify Maintena patient assistance programs?
ABILIFY MAINTENA patient assistance information can be found through Otsuka America. Visit Here →
Where can I find Abilify Maintena prescribing information?
ABILIFY MAINTENA prescribing information can be found at the link below: Visit Here →
Where can I find Abilify Maintena side effect information?
Information regarding ABILIFY MAINTENA's side effects can be found at MedlinePlus Visit Here →
Does billing ABILIFY MAINTENA require JZ/JW wastage modifiers?
CMS has identified ABILIFY MAINTENA(J0401) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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