Pharmacy reimbursement for COVID-19 antiviral drugs paxlovid and molnupiravir, according to pre-publication guidance from NCPDP, will be the SUM of the pharmacy’s regular contracted dispensing fee plus an “enhanced dispensing fee” claimed in the incentive fee field. Claims should include the professional service code “PE” in order to trigger the PBM logic to pay an incentive fee. Read more about reimbursement for these drugs on NCPA’s COVID-19 Therapeutics page. Report billing issues here after seeking support from the pharmacy help desk.
NCPA
