Cost of Dispensing Survey

Tuesday, March 16, 2021

The five-year cost of dispensing (COD) survey has been completed for NC pharmacies. Myers and Stauffer LC performed the survey of pharmacy COD, consistent with Centers for Medicare and Medicaid Services (CMS) guidelines, on behalf of NC Medicaid.

NC pharmacies actively participating in Medicaid and NC Health Choice between Jan. 1, 2019, and April 30, 2020, were surveyed, with a 43.2% response rate. The findings of the survey were consistent with the 2015 survey; therefore, no changes will be made to the professional dispensing fee at this time. 

As a reminder, the Medicaid Managed Care health plans, have opted to pay a flat rate of $10.24 for all pharmacy claims billed through the health plans. This change will occur effective July 1, 2021. All NC Medicaid Direct (traditional fee-for-service) claims will continue to be paid utilizing the tiered payment model, designed to incentivize dispensing of preferred generics and brands.

The COVID-19 relief increase of 5% per claim and an additional payment for shipping and deliveries will remain in effect throughout the public health emergency. 

Contact

NCTracks Call Center, 800-688-6696