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Billing with National Drug Codes (NDCs)

April 13, 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" until July 14, 2012. 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 will continue to accept NDC for billing of all physician-administered and physician-supplied drugs.

Effective July 15, 2012, immunizations submitted with an NDC will be reimbursed in accordance with the schedule posted on the website under “Drugs” based on the applicable Current Procedural Terminology (CPT®) code(s) included on the claim.  BCBSTX will continue to accept NDC for billing of all physician-administered and physician-supplied drugs, including immunizations.

For more information, go to General Reimbursement Information.