| Carrier Name | List of HCPC Codes for Naloxone | Modifier | Other Notes |
|---|---|---|---|
| Aetna Health, Inc. and Aetna Life Insurance Company | J2310, J2311, J3490 | Use Revenue Code 636 | |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | J3490 | HG | Include apropriate 11-digit NDC code and Revenue code 636 (when billing on a UB) |
| Boston Medical Center Health Plan, Inc. d/b/a WellSense Health Plan | J3490 | HG | Use Revenue Code 636 |
| Cigna Health and Life Insurance Company | J0571, J0572, J0573, J0574, J0575, J0592, J1230, J2310, J2311, J2315 | ||
| Fallon Community Health Plan, Inc. | J2310, J2311, J3490 | ||
| Harvard Pilgrim Health Care, Inc. | J0571, J0572, J0573, J0574, J0575, J2310, J2311 | ||
| Health New England, Inc. | J3490 | HG | Use Revenue Code 636 |
| Mass General Brigham Health Plan, Inc. | J3490 | ||
| Tufts Health Public Plans, Inc. | J0571, J0572, J0573, J0574, J0575, J2310, J2311 | ||
| UnitedHealthcare Insurance Company | J2310, J2300, J2315, J3490 | Use Revenue Code 636 |
Opioid Antagonist Carrier Facility Codes
*Updated 1/1/23