MedicaidReimbursementLow impact
Newsletter Vol. 5, No. 32
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, Pediatrics +2 more·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has removed Federal Medicaid Upper Limits (MAC) for two pharmaceutical products: Cortisporin otic solution (effective March) and Chloromycetin oral capsules (effective April). Reimbursement will now be based on Average Wholesale Price (AWP) minus regression/discount plus dispensing fee, or provider's usual and customary charge, whichever is lower.
Action Required
By March 2024: Update pharmacy billing systems to reflect new reimbursement methodology for Cortisporin otic solution - use AWP minus applicable discounts plus dispensing fee instead of MAC pricing. By April 2024: Apply same reimbursement changes for Chloromycetin oral capsules. Verify billing system calculates lower of AWP-based price or usual and customary charge.