20 Miss. Code R. § 2-IV

Current through June 25, 2024
Section 20-2-IV - REIMBURSEMENT
A. Reimbursement for pharmaceuticals ordered for the treatment of work-related injury/illness is as follows:
1. Brand/Trade Name Medications: Average Wholesale Price (AWP) plus a five dollar ($5.00) dispensing fee.
2. Generic Medications: Average Wholesale Price (AWP) minus 5% plus a five dollar ($5.00) dispensing fee.
3. Over-the-counter medications are reimbursed at usual and customary rates.
4. Dispensing fees are payable only if the prescription is filled under the direct supervision of a registered pharmacist. If a physician dispenses medications from his/her office, a dispensing fee is not allowed.
B. Supplies and equipment used in conjunction with medication administration should be billed with the appropriate HCPCS codes and shall be reimbursed according to the Fee Schedule. Supplies and equipment not listed in the Fee Schedule will be reimbursed at the usual and customary rate.
C. Mail-order pharmaceutical services are subject to the rules and reimbursement limitations of this Fee Schedule when supplying medications to Mississippi Workers' Compensation claimants. Shipping for mail-order pharmaceutical services is not separately reimbursed.

20 Miss. Code. R. § 2-IV

Amended 6/14/2017
Amended 6/15/2019