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Billing with National Drug Codes (NDCs)

October 4, 2012

Effective February 1, 2013 BCBSTX will begin reimbursing “Not Otherwise Classified” (NOC) physician administered and physician supplied drugs in accordance with the National Drug Code (NDC) schedule posted on the website under "Drugs".  The NDC allowable listed is based on NDC units and should be billed appropriately.  BCBSTX requires inclusion of the NDC along with the applicable Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT®) code(s) on claim submissions for unlisted or “Not Otherwise Classified” (NOC) physician administered and physician supplied drugs. BCBSTX will continue to accept NDC for billing of all physician administered and physician supplied drugs, including immunizations.

Note: The “Not Otherwise Classified” (NOC) Drug Fee Schedule will be updated on the first of each month.


Recap of NDC History:

December  2011

For the most current information on Billing with National Drug Codes (NDCs), go to the Billing with National Drug Codes article posted on 2/01/2012 located in the News & Updates (View All) area of this website or

View NDC guidelines .

September 2011

In September 2011, Blue Cross and Blue Shield of Texas (BCBSTX) announced that claims submitted with an NDC will be reimbursed in accordance with the NDC schedule posted on the website under "Drugs" effective January 1, 2012.   Effective March 1, 2012 BCBSTX will temporarily discontinue reimbursing claims submitted with an NDC in accordance with the NDC schedule posted on the website under "Drugs" with the exception of immunizations.  Immunizations submitted with an NDC will continue to be reimbursed in accordance with the NDC schedule posted on the website under "Drugs".  Drugs other than immunizations submitted with an NDC will be reimbursed in accordance with the schedule posted on the website under “Drugs” based on the applicable Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT®) code(s) included on the claim.    

BCBSTX currently accepts NDC for billing of all physician administered and physician supplied drugs. Including the NDC on claims helps provide a more consistent pricing methodology for payment and will also facilitate better management of drug associated costs. Physicians are encouraged to begin including the NDC information on claims as soon as possible. For information about how to add the additional NDC and other required elements, please refer to the BCBSTX provider website. BCBSTX will continue to accept the HCPCS or CPT code elements without NDC information (excluding unlisted or "Not Otherwise Classified" drugs).  BCBSTX requires inclusion of the National Drug Code (NDC) along with the applicable Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT®) code(s) on claim submissions for unlisted or “Not Otherwise Classified” (NOC) physician administered and physician supplied drugs.