N.J. Admin. Code § 10:167A-1.14

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:167A-1.14 - Covered pharmaceutical services

(a) All covered pharmaceutical services shall be provided within the scope of the Medicaid or PAAD programs, and billed to the fiscal agent using the NCPDP claim format available at http://www.njmmis.com/downloadDocuments/NJ_D-0_NCPDP_Payer_Sheet.pdf.

(b) Covered pharmaceutical services include:

1. Prescribed legend drugs (for their medically accepted indication) as defined in Section 1927(k)(6) of the Social Security Act.

2. Non-legend drugs, as follow:

i. Insulin needles and/or syringes;

ii. Insulin; and

iii. Syringes and needles for injectable medicines.

N.J. Admin. Code § 10:167A-1.14

Amended by R.1998 d.464, effective 9/8/1998.
See: 30 N.J.R. 2197(a), 30 N.J.R. 3309(a).
Recodified from N.J.A.C. 8:83C-1.12 by R.2003 d. 248, effective 6/16/2003.
See: 34 N.J.R. 3456(a), 35 N.J.R. 2642(a).
Former N.J.A.C. 8:83C-1.14, Quantity of medication, recodified to N.J.A.C. 8:83C-1.16.
Amended by R.2009 d.293, effective 10/5/2009.
See: 41 N.J.R. 1637(a), 41 N.J.R. 3804(a).

Amended by 49 N.J.R. 446(a), effective 3/6/2017