MedicaidBilling CodesMedium impact
Billing Guidance for Paxlovid (TM) prescribed by enrolled Pharmacist Renderers Under EUA
Alaska Medicaid·AK · Pharmacy, Family Medicine, General Practice·Billing & Coding
Effective date
Jul 7, 2022
We identified it
Jun 21, 2026
Summary
Alaska Medicaid now allows enrolled pharmacists to prescribe Paxlovid under FDA Emergency Use Authorization, with specific billing requirements for test-to-treat services and dispensing fees. Billing providers must formally affiliate with enrolled pharmacists and use their NPI when submitting claims for evaluation and management services.
Action Required
Alaska providers only: Ensure pharmacists are enrolled as rendering providers and formally affiliated with billing organizations. Update billing systems to use pharmacist NPIs in rendering provider field for Paxlovid prescribing services using CPT codes 99202, 99211, or 99212. Pharmacies must use prescribing pharmacist's NPI in NCPDP field 411-DB when dispensing. Do not assess patient cost-sharing for these services.