CommercialBilling CodesHigh impact
Billing Services for National Drug Codes
Blue Cross Blue Shield of Vermont·VT·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Starting January 1, 2026, professional claims (CMS 1500) that require National Drug Codes (NDC) will be denied if NDC is not reported. Beginning July 1, 2026, facility claims (UB 04) will also require NDC reporting, and both professional and facility claims must include Unit of Measure (UoM) and quantity when NDC is required.
Action Required
By January 1, 2026: Billing team must update CMS 1500 claim submission processes to include National Drug Codes (NDC) for all applicable drug services. By July 1, 2026: Update UB 04 facility claim processes to include NDC reporting and ensure both professional and facility claims include Unit of Measure (UoM) and quantity when NDC is required. Review Section 6.7 of Provider Handbook for specific NDC guidelines. Claims missing required NDC information will be denied and require corrected claim resubmission.