J0395 Arbutamine hcl injection

Injection, arbutamine hcl, 1 mg

Payer policies and prior authorization for J0395

Payer coverage policies that name J0395

J0395 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaInjectable Medications (0020)listed, no stance (range J0278-J2543)Mar 5, 2026payer document

Medicaid fee-for-service

  • KY: $0.00 (asc), effective Jan 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.