MedicaidAdministrativeHigh impact
Medicaid NDC Submissions – Reimbursement Policy Update
EmblemHealth·NY·Provider News
Effective date
Oct 1, 2021
We identified it
Jun 20, 2026
Summary
Beginning October 1, 2021, New York requires National Drug Code (NDC) numbers on all Medicaid, HARP, and Child Health Plus claims for physician-administered drugs. Claims with missing or invalid NDC information may be resubmitted with correct NDC codes for reconsideration.
Action Required
Effective October 1, 2021: Billing team must ensure all Medicaid, HARP, and Child Health Plus claims include valid NDC numbers when billing for physician-administered drugs. Update billing system to require NDC entry for drug administration claims. Train staff that 340B providers cannot use 'UD' modifier as exemption - valid NDC codes are still required. Claims with missing/invalid NDC information will need resubmission.