MedicaidBilling CodesMedium impact
New National Drug Code Requirements for Manually Priced Vaccines and Toxoids
Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, Pediatrics +1 more·Pharmacy
Effective date
May 9, 2016
We identified it
Jun 20, 2026
Summary
Starting May 9, 2016, Connecticut Medicaid requires HIPAA-standard 11-digit National Drug Codes (NDCs) on all claims for manually priced vaccines and toxoids (CPT codes 90284-90738). Claims without properly formatted NDCs will be denied with EOB code 0861.
Action Required
Immediately: Billing team must update all Connecticut Medicaid claims for manually priced vaccines and toxoids (CPT 90284-90738) to include HIPAA-standard 11-digit NDC codes. Verify NDC formatting requirements in Chapter 8 of the CMAP website. Failure to include properly formatted NDCs will result in claim denials with EOB code 0861.