Summary
New Jersey Medicaid updated the MAC (Maximum Allowable Charge) drug listing with additions to the multiple-source drug list and revised upper payment limits, effective December. Billing teams must replace the previous MAC drug list (Rev.) with the new MAC drug list (Rev.) and identify drugs marked with asterisks as new additions subject to the updated payment limits.
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What to do
Action · 5 steps
01By December 2023: Billing team and pharmacy staff must (1) obtain the new MAC Drug List Rev.
02attached to Newsletter Vol.
032, No. 66 from the New Jersey Medicaid program; (2) replace the previous MAC drug list (Rev.) in your policy manual with the new list; (3) identify all drugs marked with asterisks as new additions to the MAC listing; (4) update billing system drug reference files to reflect new MAC upper payment limits; (5) retain Newsletter Vol.
042, No. 66 numerically behind the Newsletter tab with BLUE TAB MARKED in your manual; and (6) discard the old MAC drug listing.
05For questions, contact the New Jersey Medicaid program Chief Pharmacy Consultant or your Medicaid District Office.
If missed: Failure to update MAC limits in billing systems will result in incorrect reimbursement claims and potential overpayment recovery.
Original notice
Newsletter Vol. 2, No. 66
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 2, No. 01HighEffective Jan 1, 2025 · Provider NoticeNewsletter Vol. 2, No. 02HighEffective Jan 1, 2024 · ReimbursementNewsletter Vol. 2, No. 03MediumNo effective date · CodingNewsletter Vol. 2, No. 04HighEffective Dec 1, 1991 · Provider NoticeBrowse every New Jersey Medicaid change in the policy list