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Elizabeth M. Whitehorn, Director

Provider Notice issued 09/20/2024

 

To: Enrolled Pharmacies
​Date September 20, 2024
​Re:
 COVID-19 Vaccine – 2024-2025 National Drug Codes

This notice updates pharmacies regarding billing for the new 2024-2025 COVID-19 vaccines. This update applies to the Medicaid fee-for-service (FFS) program and the managed care organizations (MCOs).

Pharmacies may bill claims with the correct National Drug Code (NDC) for the 2024-2025 COVID-19 billing season. Pharmacies billing FFS must use “MA” in the Professional Service Code Field, in addition to identifying the administration fee.

For managed care claims, please contact the applicable MCO for rate and payment details as well as billing instructions.

Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.

 

Kelly Cunningham, Administrator
Division of Medical Programs