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January 2020
Drugs to treat members with opioid use disorder and behavioral health conditions now payable in home or AICs
In the October 2018 Record, we reported that beginning Jan. 1, 2019, select injectable medications will be payable in the home setting through home infusion therapy and in ambulatory infusion centers without requiring medical IV therapy on the same day. We’ve expanded the list of applicable drugs to assist members struggling with opioid addiction and chronic behavioral health conditions.
The following drugs are now included in the list of injectable medications payable in ambulatory infusion centers or the home setting by HIT providers for Blue Cross Blue Shield of Michigan’s PPO plans:
| Procedure code |
Drug name |
| J0401 |
Injection, aripiprazole, extended release, 1 mg |
| J1943 |
Injection, aripiprazole lauroxil (aristada initio), 1 mg |
| J1944 |
Injection, aripiprazole lauroxil (aristada), 1 mg |
| J2680 |
Injection, fluphenazine decanoate, up to 25 mg |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
| J2358 |
Injection, olanzapine, long-acting, 1 mg |
| J2426 |
Injection, paliperidone palmitate extended release, 1 mg |
| J2798 |
Injection, perseris, 0.5 mg |
| J2794 |
Injection, risperidone, long acting, 0.5 mg |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
| Q9991 |
Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg |
| Q9992 |
Injection, buprenorphine extended-release (sublocade), greater than 100 mg |
Want to be listed among our HIT or AIC providers?
We’ll be compiling a list of HIT and AIC providers who have indicated they are accepting members for this service and will be posting the list on the Find a Doctor feature on bcbsm.com. This will make it easier for members who are looking for an HIT or AIC provider to find you.
If you’d like to be included on this list, contact your provider consultant.
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