J3120 Testosterone enanthate inj

Injection, testosterone enanthate, up to 100 mg

Payer policies and prior authorization for J3120

Payer coverage policies that name J3120

J3120 appears in 3 coverage policies from Aetna, BlueCross BlueShield of South Carolina, Centene.

PayerPolicyRole in policyReviewedDocument
AetnaInjectable Medications (0020)listed, no stance (range J2550-J3520)Mar 5, 2026payer document
BlueCross BlueShield of South CarolinaTestosterone Replacement Therapies (CAM 50123)listed, no stanceApr 1, 2026payer document
CenteneTestosterone (CP.CPA.291)
Reviews, Revisions, and Approvals | Date | P&T		covered if criteria are metNov 1, 2025payer document

Medicaid fee-for-service

  • WY: $0.00 (professional), effective Jan 1, 2015

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.