Immunizing Pharmacists Enrollment and Pharmacy Reimbursement on a Medical Claim for Self-Administered Hormonal Contraceptive Protocol Beginning January 2024

NC Medicaid will allow immunizing pharmacists to enroll as providers using the Ordering, Prescribing, and Referring (OPR) Lite application starting on Jan. 8, 2024 and will begin reimbursing enrolled pharmacists for utilization of the Self-Administered Hormonal Contraceptive Protocol.

The Immunizing Pharmacist must follow all enrollment instructions outlined in the Dec. 20, 2023, NC Medicaid bulletin Immunizing Pharmacists Enrollment Opening in January 2024.

The Pharmacy NPI is required to be entered as the billing and rendering provider on the medical claim. The Immunizing Pharmacist NPI is required to be entered as the ordering provider. All required codes sets including taxonomies, procedure codes, diagnosis codes and modifier must be included on the medical claim as outlined in the NC Medicaid bulletin.

Providers are required to comply with all limitations and restrictions as documented in the NC Medicaid bulletin and are subject to audit of records by NC Medicaid.