J8502 Inj, aponvie, 1 mgInjection, aprepitant (aponvie), 1 mg
J8502 payment limit: $1.998 per 1 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
47426-0401-10 Aponvie, Heron Therapeutics: 320 billing units per package (10 VIAL, GLASS in 1 CARTON / 4.4 mL in 1 VIAL, GLASS)Status E: excluded from the PFS by regulation.
6 of 6 payer prior-auth lists that name J8502 require prior authorization or set conditions: HealthSpring, Humana, Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of New Mexico, Passport by Molina Healthcare (Kentucky).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| HealthSpring | Medicare Advantage | All | prior auth required | Jan 1, 2025 | 2026 Q4 Prior Authorization List | |
| Humana | Humana Healthy Horizons | OK | prior auth required | Oct 14, 2026 | Humana Healthy Horizons in Oklahoma Prior Authorization and Notification List | |
| Molina Healthcare of California | Medicaid | CA | prior auth required | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 | |
| Molina Healthcare of Illinois | Medicaid | IL | prior auth required | Jan 27, 2026 | Molina Healthcare of Illinois Codification Grid Q3 2026 | |
| Molina Healthcare of New Mexico | Medicaid | NM | prior auth required | Apr 1, 2026 | New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026 | |
| Passport by Molina Healthcare (Kentucky) | Medicaid | KY | prior auth required | Apr 1, 2026 | Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026 |
J8502 appears in 3 coverage policies from Aetna, Centene.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Antiemetic Therapy (0724) | covered if criteria are met | Jul 17, 2026 | payer document |
| Aetna | Revakinagene Taroretcel-lwey (Encelto) (1079) | listed, no stance (range J8501-J9999) | Oct 5, 2026 | payer document |
| Centene | Aprepitant (Aponvie, Emend, Cinvanti), Fosaprepitant (Emend for Injection, Focinvez) (CP.PMN.19) | covered if criteria are met | Aug 1, 2026 | payer document |
Prior authorization required or conditional in VA, WA.
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.