MedicaidReimbursementMedium impact
Newsletter Vol. 11, No. 76
New Jersey Medicaid·NJ · Pharmacy·Pharmacy
Effective date
Aug 24, 2001
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid updated the Maximum Allowable Cost (MAC) pricing for generic Benztropine Mesylate (Cogentin) effective August 24, 2001. The policy establishes three new MAC reimbursement rates based on tablet strength (0.5mg, 1mg, and 2mg), ranging from $0.0898 to $0.1027 per unit. Billing teams must update their fee schedules and pharmacy billing systems to reflect these new MAC prices to avoid claim underpayment or rejection.
Action Required
By September 30, 2001: Billing and pharmacy teams must update all Medicaid reimbursement fee schedules in the billing system to reflect the new MAC prices for Benztropine Mesylate. Update pricing as follows: 0.5mg tablet = $0.0898, 1mg tablet = $0.0930, 2mg tablet = $0.1027 per 100-count package. Verify that all claims submitted for these drug strengths on or after August 24, 2001 use the updated pricing. Failure to update pricing may result in claim denials or payment adjustments.