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This is an obsolete version of the rule. Please click on the rule number to view the current version.

37.85.905    PHYSICIAN ADMINISTERED DRUGS, REQUIREMENTS

(1) Effective April 1, 2008, all billable claim lines submitted for physician administered drugs must include the NDC, the corresponding HCPCS code, and the units administered for each code.

(a) Claim lines billed for HCPCS that represent physician administered injections will be denied if there is no NDC on the line.

(b) Reimbursement will be made only on those drugs manufactured by companies that have a signed rebate agreement with the CMS.

(2) The requirements of this rule do not apply to claims reimbursed under all-inclusive payment methodologies.

History: 53-2-201, 53-6-113, MCA; IMP, 53-6-101, MCA; NEW, 2008 MAR p. 956, Eff. 5/9/08.

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