MedicaidReimbursementMedium impact
Newsletter Vol. 4, No. 27
New Jersey Medicaid·NJ · Pharmacy·Provider Notice
Effective date
Mar 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is deleting Butabarbital Sodium (Butisol Sodium) from the Federal Medicaid Upper Limits (MAC) list effective March 2024. Reimbursement for this drug will now be based on the lower of AWP minus applicable discounts plus dispensing fee or Usual and Customary Charge. Additionally, a correction is issued for Cortisporin Otic Suspension MAC pricing previously reported in error.
Action Required
By March 2024: Pharmacy billing team must update billing system to remove Butabarbital Sodium (Butisol Sodium) tablets from MAC list lookups in New Jersey Medicaid claims processing. Configure system to calculate reimbursement using AWP minus regression discounts (if applicable) plus dispensing fee, or UCR, whichever is lower. Verify that Cortisporin Otic Suspension (Hydrocortisone-Neomycin-Polymixin B Sulfate) is priced per corrected MAC rate (not the previously incorrect rate reported in Vol. 4, No. 25). Update claim submission logic in billing software and train pharmacy staff on new reimbursement methodology for these drugs. Failure to implement may result in claim denials or payment adjustments from NJMMIS for these affected drugs.