Agencies
Services
Provider Notice issued 11/13/2025
Compound Claims Paying at Zero
| To: |
Enrolled Pharmacies |
| Date | November 13, 2025 |
| Re: |
Compound Claims Paying at Zero |
The purpose of this notice is to inform pharmacy providers that the claims adjudication system is now able to process and pay compound claims. The processing system had been paying compound claims at zero since the Change Healthcare outage in March 2024.
At this time, pharmacy providers are encouraged to void and rebill those claims that were either paid at zero or held pending restoration. This applies to fee-for-service (FFS) billing only.
Please call the Bureau of Professional and Ancillary Services at 877-782-5565 and speak to a pharmacy consultant to obtain any necessary overrides on rejections that may occur while rebilling these claims.
Laura Phelan, Administrator
Division of Medical Programs