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See a sample rate comparisonHCPCS J1943 (Aristada Initio) Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, aripiprazole lauroxil, (aristada initio), 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1943 |
| Medicare Payment Limit | $3.245  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 65757-0500-03 - ARISTADA INITIO (LATEX-FREE) 675 MG/2.4 ML |
National average reimbursement for HCPCS J1943 by major payers:
$3.37
$3.28
$3.43
$3.39
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HCPCS J1943
5 of 25 sample ratesHigher to lower in this preview
Timur Mushekov
Montefiore Medical Center
$7.86Published rateRebecca Stonis
Cleveland Clinic Health System East Region
$3.69Published rateSt. Charles Hospital Corp.
St Charles Hospital Corp
$3.31Published rateHalifax Hospital Medical Center, Halifax Medical Center
$3.14Published rateHazel Hawkins Memorial Hospital, San Benito Health Care District
$3.13Published rate
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See a sample payer proposalHCPCS J1943 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1943 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J1943 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 65757-0500-03-NDC | Moderate | ARISTADA INITIO (LATEX-FREE) 675 MG/2.4 ML |
| J1941-HCPCS | Moderate | Injection, furosemide (furoscix), 20 mg |
| J1943-HCPCS | Low | Injection, aripiprazole lauroxil, (aristada initio), 1 mg |
| J1944-HCPCS | Low | Injection, aripiprazole lauroxil, (aristada), 1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1943. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1943 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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