MedicaidDocumentationHigh impact
NDC/Quantity Required when Billing for Drugs
Maryland Medicaid·MD·General Provider
Effective date
Jan 1, 2008
We identified it
Jun 20, 2026
Summary
Starting January 1, 2008, Maryland Medicaid requires providers to include valid 11-digit NDC numbers and quantities on CMS-1500 forms when billing for physician-administered drugs using J-codes. Claims without proper NDC/quantity reporting will not be reimbursed, and drugs must be from manufacturers participating in the Medicaid Drug Rebate Program.
Action Required
By January 1, 2008: Billing team must update CMS-1500 forms to include 11-digit NDC numbers with qualifier N4 and quantity administered with appropriate unit qualifiers (F2, GR, ML, UN) in Box 24A for all J-code drug billing. Verify all drugs are from manufacturers participating in Medicaid Drug Rebate Program. Train staff on proper NDC formatting including left-zero padding. Claims without valid NDC/quantity will be denied reimbursement.