Point-of-Sale Processing for Ohio Medicaid Pharmacy Claims
The pharmacy and prescriber NPI are required on all point-of-sale and paper claims submissions. Please see the payer sheet below. Claims submitted with a service provider ID other than NPI will be rejected.
- The pharmacy's NPI should be submitted in NCPDP version 5.1 field #201-B1 (service provider ID), with field #202-B2 (service provider ID qualifier) submitted as 01 (NPI).
- The prescriber ID in fields #411-DB (prescriber ID) and #466-EZ (prescriber ID qualifier) must be submitted as NPI (qualifier 01).
Helpful Links
ACS Provider Manual - Revised January 2012
Request for Prior Authorization Form
Prior Authorization form for Synagis Administered in the Home
ACS payer sheet - Effective January 1, 2012
Pharmacy Rules
Quantity Limits - Effective February 1, 2010
Federal Requirement for Tamper-Resistant Prescription Pads Effective April 1, 2008
CyberAccess tool - free web site for providers to securely view Medicaid consumers' Rx claims
Covered Active Pharmaceutical Ingredients and Excipients for Compounding