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NC Medicaid »   Home »   blog

SPECIAL BULLETIN COVID-19 #216: Pharmacies Will Cover Oral Tablets (Paxlovid and Molnupiravir) Oral tablets covered for those in a home setting

January 14, 2022

Effective Jan. 1, 2022, NC Medicaid-enrolled pharmacies may bill for FDA/EUA-approved COVID-19 oral tablets (Paxlovid and/or Molnupiravir) dispensed for use to NC Medicaid beneficiaries in a home setting, with a prescription issued by an NC Medicaid-enrolled provider (refer to beneficiaries’ managed care plan for guidance on the specific plan’s implementation date).

  • NC Medicaid will cover one claim per date of service per beneficiary.
  • The claim must have a prescribing provider. 
  • Pharmacies must follow the NCPDP standard and use the NDC found on the package.
  • Pharmacies will be NOT be reimbursed for the ingredient cost since the drugs are federally provided at no cost. 
  • Dispensing fee will apply.
  • Copayment will not apply.

For more information, see FDA letters:

  • Paxlovid EUA
  • Molnupiravir EUA

CONTACT

NCTracks Contact Center: 800-688-6696

This blog is related to:

  • Bulletins
  • COVID-19
  • Pharmacy Providers
  • Physicians, Physician Assistants and Nurse Practitioners

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https://medicaid.ncdhhs.gov/blog/2022/01/14/special-bulletin-covid-19-216-pharmacies-will-cover-oral-tablets-paxlovid-and-molnupiravir