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MedicaidAdministrativeMedium impact

BT2023163: IHCP reminds pharmacy providers to submit claims with appropriate DAW codes

Indiana Medicaid (IHCP)·IN·Pharmacy
Effective date
Nov 21, 2023
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Medicaid (IHCP) reminds pharmacy providers to use correct DAW codes when submitting claims: DAW code '9' for preferred brand drugs over generics, and DAW code '8' when preferred brand drugs are unavailable in the marketplace.

Action Required

Action needed
Immediately: Pharmacy billing staff must verify DAW codes on all Indiana Medicaid claims - use DAW code '9' when dispensing preferred brand drugs over generics, and DAW code '8' when preferred brand drugs are unavailable (must verify unavailability with at least two wholesalers and document on prescription). Failure to use correct DAW codes will result in generic reimbursement rates instead of brand reimbursement.