Oral tablets covered for those in a home setting
Topics Related to Pharmacy Providers
FDA has expanded the use of single booster dose to include ages 12-15.
Effective with date of service Jan. 1, 2022 (updated from Sept. 29, 2021), the Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine (12 years of age and older).
Update on COVID-19 booster shot recommendations for Pfizer, Moderna and Janssen
On Sept. 24, 2021, the Centers for Disease Control and Prevention (CDC) made the following recommendations:
NC Medicaid licensed pharmacists are authorized to order and administer REGEN-COV monoclonal antibodies and pharmacy technicians/interns may administer it, in accordance with the conditions of their licensure and/or scope of practice.
The FDA has modified the Emergency Use Authorizations (EUAs) for Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine to allow for administration of a third dose of an mRNA COVID-19 vaccine after an initial two-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people.
Not required for medications administered at the provider’s office or outpatient hospital clinic settings and billed as part of the professional claim (Physician Administered Drug Program).
Providers and pharmacies should always use NCTracks to confirm eligibility.
Guidance to pharmacies on prior authorizations that transfer from a health plan to NC Medicaid Direct.