MedicaidAdministrativeHigh impact
[Ohio] Requirements for Including NDC with Certain HCPCS and CPT codes
CareSource·OH·Pharmacy
We identified it
May 9, 2026
Summary
CareSource (Ohio) now requires National Drug Code (NDC) numbers to be included when billing certain HCPCS and CPT codes for pharmaceutical services. This applies to drug administration, injection, and infusion procedures to ensure proper drug tracking and reimbursement.
Action Required
Immediately: Billing team must update claim submission processes to include NDC numbers for all pharmaceutical-related HCPCS and CPT codes when billing CareSource Ohio plans. Update billing software to require NDC entry for drug administration procedures. Train staff on proper NDC lookup and entry procedures. Claims missing required NDC information may be denied or delayed.