Home Drug Codes J Codes J1943 · ARISTADA INITIO
Updated July 1st, 2026

ARISTADA INITIO J Code: J1943

Injection, aripiprazole lauroxil, (aristada initio), 1 mg

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Q4 2026 Medicare Payment Limit for J1943, effective October 1, 2026: $3.459 per HCPCS billing unit, down 0.1% from $3.461. From CMS's final file.

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Medicare Payment Limit ?
$3.461
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$3.461
/ HCPCS billing unit · APC 9179
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, aripiprazole lauroxil, (aristada initio), 1 mg
HCPCS Added Date October 1, 2019
Manufacturer Alkermes
Route of Administration Intramuscular
Generic Status Single-Source; Branded
Dosage Form Injection, Suspension, Extended Release

About ARISTADA INITIO

Aristada Initio is a medication aligned to the HCPCS J Code: J1943 for billing, pricing, and reimbursement purposes in the United States. Classified under Psychiatric, it is administered via the intramuscular route and manufactured by Alkermes.

According to CMS Drug Use Information: Drug uses not available

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. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
65757-0500-03 Aristada Initio Alkermes, Inc. 675 675 MG / 2.4 ML
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ARISTADA INITIO Pricing & Reimbursement

J1943 Private Payer Reimbursement
$3.21 / 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

Aripiprazole Lauroxil 505(b)(2) Information:

HCPCS Code Manufacturer Active Ingredient HCPCS Description
J1943 Alkermes Aripiprazole Lauroxil Injection, aripiprazole lauroxil, (aristada initio), 1 mg
J1944 Alkermes Aripiprazole Lauroxil Injection, aripiprazole lauroxil, (aristada), 1 mg

ARISTADA INITIO 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 Aristada Initio (J1943) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ARISTADA INITIO Medically Unlikely Edits (MUE)

The most billing units of J1943 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
675 units / day
= 675 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.

ARISTADA INITIO 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.

Schizophrenia
Drug Class
Atypical Antipsychotic [EPC]

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Frequently Asked Questions

Is there an available Aristada Initio billing and coding guide?
Billing and coding information for ARISTADA INITIO can be found through Alkermes. Visit Here →
Are there any available Aristada Initio patient assistance programs?
ARISTADA INITIO patient assistance information can be found through Alkermes. Visit Here →
Where can I find Aristada Initio prescribing information?
ARISTADA INITIO prescribing information can be found at the link below: Visit Here →
Where can I find Aristada Initio side effect information?
Information regarding ARISTADA INITIO's side effects can be found at MedlinePlus Visit Here →
Does billing ARISTADA INITIO require JZ/JW wastage modifiers?
CMS has identified ARISTADA INITIO(J1943) 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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