Since August 2023, when the State Health Director Standing Orders ended and the Statewide Board of Pharmacy Protocols became effective, use of the Pharmacy National Provider Identifier (NPI) as the prescriber on Point-of-Sale (POS) claims for protocol drugs has been allowed. This was necessary to pay claims submitted for dispensing a protocol drug.
For Reference, see the August 2023 Pharmacy Newsletter article titled “State Health Director Standing Orders to be replaced by State Protocols in August 2023” for details about the transition. An excerpt from that article is included below:
“The protocols are intended for pharmacist use; however, immunizing pharmacists are not currently enrolled providers in NC Medicaid. Until pharmacists have the ability to enroll in NC Medicaid as a provider the pharmacy NPI should be used as the prescriber when utilizing the protocols for a NC Medicaid beneficiary…”
Policy Change
Effective May 2, 2026, the pharmacy NPI will no longer be allowed in the prescriber field on POS claims for any of the below five categories of Statewide BOP Protocols.
- Nicotine Replacement Therapy
- Hormonal Contraception
- Prenatal Vitamin
- Glucagon
- HIV PEP
Provider Guidance
Immunizing Pharmacists are encouraged to become a NC Medicaid provider. The Pharmacy Newsletter regularly features an article about the January 2024 launch of Immunizing Pharmacist enrollment as an Ordering, Prescribing, or Referring (OPR) provider. Most recently, Immunizing Pharmacist Enrollment in NC Medicaid Contraceptives and NRT Protocol Reimbursement to Pharmacies” was in the February 2026 Pharmacy Newsletter. The article has information about how to enroll and reimbursements for the protocols.
Contact
Starting May 2, 2026, contact: Prime Therapeutics Call Center: 844-620-6116
Through May 1, 2026, contact: NCTracks Call Center: 800-688-6696