Medicaid NDC Submissions – Reimbursement Policy Update

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Medicaid NDC Submissions – Reimbursement Policy Update

12/15/2021

Beginning Oct. 1, 2021 New York Health Department regulations require National Drug Code (NDC) numbers for Medicaid, HARP, and Child Health Plus claims which include physician-administered drug services.

Claims submitted with missing, invalid, incomplete NDC information, etc. may be resubmitted with the appropriate NDC information for reconsideration. This requirement also applies to 340B providers; appending a modifier of “UD” is not an exemption; valid NDC codes must be included on claims.

For more information on NDC requirements including frequently asked questions, see our National Drug Code (NDC) Submissions Reimbursement Policy or visit the State of New York Health Department website at New York State Medicaid Update - August 2021 Volume 37 - Number 10.

For Commercial and Medicare members see the Claims Corner, Reimbursement Policy section for NDC policy update.

 

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