MedicaidReimbursementLow impact
Newsletter Vol. 4, No. 19
New Jersey Medicaid·NJ · ENT (Ear, Nose & Throat), Family Medicine, Pediatrics·Pharmacy
Effective date
Feb 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid increased the drug price upper limit for Cortisporin Otic Suspension (hydrocortisone/neomycin/polymyxin B) to $1,671.82 effective February 1st. Reimbursement will be based on the lower of AWP minus discounts plus dispensing fee, the new Medicaid upper limit plus dispensing fee, or usual and customary charge.
Action Required
Immediately: Pharmacy billing staff should update drug pricing systems to reflect the new Medicaid upper limit of $1,671.82 for Cortisporin Otic Suspension. Verify that billing software uses the correct reimbursement methodology (lower of AWP minus discounts plus dispensing fee, MAC price plus dispensing fee, or usual and customary charge) for New Jersey Medicaid claims.