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CareSourceMedicaid · Administrative · Pharmacy · OHHigh impact

[Ohio] Requirements for Including NDC with Certain HCPCS and CPT codes

Act
immediately
Effective date
Not stated in the notice
Identified
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.

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What to do

immediately · 4 steps
01Billing team must update claim submission processes to include NDC numbers for all pharmaceutical-related HCPCS and CPT codes when billing CareSource Ohio plans.
02Update billing software to require NDC entry for drug administration procedures.
03Train staff on proper NDC lookup and entry procedures.
04Claims missing required NDC information may be denied or delayed.

Original notice

[Ohio] Requirements for Including NDC with Certain HCPCS and CPT codes
caresource.com · Always check the source before changing claims.
View original ↗

Related changes

See all CareSource changes →
[Ohio] Requirements for Including National Drug CodeHighEffective Jul 25, 2025 · PharmacyBrowse every CareSource change in the policy list

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