COVID-19 Vaccine Administration: Preparing NCPDP 1.2 and Pharmacy Hard Copy Submissions

January 13, 2021
Updated on March 3, 2021
Most recent updates are denoted with two plus signs (++)

This is the ninth article in the COVID-19 Vaccine Administration series and originally informed pharmacy providers how to prepare billing for NCPDP 1.2 submissions using Computer Media Claims (CMC) and hard copy (Pharmacy Claim Form [30-1]) claims.

++However, in order to support flexibility as additional COVID-19 vaccines are approved and administration guidance evolves, the policy the Food and Drug Administration (FDA) has provided in Emergency Use Authorizations (EUA) has been moved to vaccine-specific pages:

As other vaccine manufacturers are approved by the FDA, additional billing instructions will be issued and added as links to the COVID-19 Medi-Cal Response page.

++As of original publication of this article, providers were instructed to continue to hold submitting their NCPDP 1.2 transactions, or 30-1 claims.  As of January 19, 2021, all pharmacy claim submission types can be submitted to Medi-Cal.

For the most current direction regarding whether or not claims should be submitted, and what behavior to expect when submitting, providers should refer to the “Pharmacy Claim Submissions” and “Medical and Outpatient Claim Submissions” tables on the COVID-19 Medi-Cal Response page.