J3230 Chlorpromazine hcl injectionInjection, chlorpromazine hcl, up to 50 mg
J3230 payment limit: $16.802 per 50 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
43598-0140-25 Chlorpromazine Hcl, Dr. Reddy's Laboratories Inc.: 13 billing units per package (25 VIAL in 1 CARTON / 1 mL in 1 VIAL)43598-0141-25 Chlorpromazine Hcl, Dr. Reddy's Laboratories Inc.: 25 billing units per package (25 VIAL in 1 CARTON / 2 mL in 1 VIAL)55150-0318-25 Chlorpromazine HCl, Eugia US LLC: 13 billing units per package (25 AMPULE in 1 CARTON / 1 mL in 1 AMPULE)55150-0319-25 Chlorpromazine HCl, Eugia US LLC: 25 billing units per package (25 AMPULE in 1 CARTON / 2 mL in 1 AMPULE)65219-0128-01 Chlorpromazine HCl, FreseniUS Kabi USA, LLC: 13 billing units per package (25 VIAL in 1 CARTON / 1 mL in 1 VIAL)65219-0130-02 Chlorpromazine HCl, FreseniUS Kabi USA, LLC: 25 billing units per package (25 VIAL in 1 CARTON / 2 mL in 1 VIAL)00404-9836-01 Chlorpromazine HCl, Henry Schein Inc.: 1 billing unit per package (1 AMPULE in 1 BAG / 1 mL in 1 AMPULE)51662-1406-01 Chlorpromazine HCl, HF Acquisition Co. LLC, DBA HealthFirst: 1 billing unit per package (2 mL in 1 AMPULE)00641-1397-35 Chlorpromazine HCl, Hikma Pharmaceuticals USA Inc.: 13 billing units per package (25 AMPULE in 1 CARTON / 1 mL in 1 AMPULE)00641-1398-35 Chlorpromazine HCl, Hikma Pharmaceuticals USA Inc.: 25 billing units per package (25 AMPULE in 1 CARTON / 2 mL in 1 AMPULE)66794-0249-42 Chlorpromazine HCl, Piramal Critical Care Inc: 13 billing units per package (25 VIAL in 1 CARTON / 1 mL in 1 VIAL)66794-0250-42 Chlorpromazine HCl, Piramal Critical Care Inc: 25 billing units per package (25 VIAL in 1 CARTON / 2 mL in 1 VIAL)70710-1849-07 Chlorpromazine HCl, Zydus Pharmaceuticals (USA) Inc.: 13 billing units per package (25 VIAL in 1 CARTON / 1 mL in 1 VIAL)70710-1850-07 Chlorpromazine HCl, Zydus Pharmaceuticals (USA) Inc.: 25 billing units per package (25 VIAL in 1 CARTON / 2 mL in 1 VIAL)Status E: excluded from the PFS by regulation.
3 of 5 payer prior-auth lists that name J3230 require prior authorization or set conditions: UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| UnitedHealthcare Community Plan | KanCare | KS | prior auth required | Oct 1, 2026 | Prior authorization requirements for Kansas Medicaid Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | Pennsylvania CHIP | PA | prior auth required | Jul 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of Pennsylvania CHIP Effective July 1, 2026 | |
| UnitedHealthcare Community Plan | Pennsylvania Medicaid | PA | prior auth required | Jul 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of Pennsylvania Effective July 1, 2026 |
J3230 appears in 4 coverage policies from Aetna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Electroconvulsive Therapy (0445) | listed, no stance | Jul 29, 2026 | payer document |
| Aetna | Gastric Pacing / Electrical Stimulation and Gastroesophageal Per Oral Endoscopic Myotomy (0678) | listed, no stance | Oct 7, 2025 | payer document |
| Aetna | Hypoxic Ischemic Encephalopathy (0812) Topiramate | not covered | Nov 20, 2025 | payer document |
| Aetna | Injectable Medications (0020) | listed, no stance (range J2550-J3520) | Mar 5, 2026 | payer document |
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.