Pharmacy Resources

Below are resources and links for pharmacy services.

Pharmacy Forms

*Main Forms webpage

DOM Lists

• Covered Over-The-Counter (OTC) NDC List
• 90-Day Maintenance List – disease state format effective April 1, 2019
• 90-Day Maintenance List – effective April 1, 2019
• Clinician Administered Drugs and Implantable Drug System Devices (CADD): effective July 1, 2018 (updated 2/16/2023)
• Current Mississippi Medicaid Covered over-the-counter (OTC) drug list
• Current Mississippi Medicaid Covered over-the-counter (OTC) NDC List
• Family Planning Waiver Drugs Covered through Point of Sale (POS) – effective October 9, 2022
• Insulin products with quantity limits – effective February 2019 (updated July 2022)
• Oral Inhalers / Nebulizer Solution Quantity Limits List – effective August 2019 (updated Nov. 2020)
• Prenatal Vitamins NDC List – effective January 1, 2022 (updated Dec. 2021)
• Specialty Drug List (archived)

Miscellaneous

• Buprenorphine/Naloxone and Buprenorphine Therapy Guidance – Provider Summary – revised January 2023
• Family planning waiver renewal changes
• Stimulants – Approved Indications Coverage

Billing and Claims

• 72-hour emergency Rx supply billing directions – effective October 1, 2022
• 72-hour emergency prescription – effective October 1, 2022
• Governor declared disaster – Rx billing directions
• Hospice patients billing
• Other insurance billing instructions / cost avoidance
• Flat rate price of generics being offered in Mississippi
• MS Medicaid pharmacy contact and billing information (PCN/BIN) – eff. Oct. 1, 2022
• Mississippi NCPDP D.0 Payer Sheet 2022
• ICD-10 codes for POS claims and Smart PAs – eff. Sept. 23, 2021

Other

• Pharmacy Medicare and Medicaid relationship
• Tamper resistant prescription pad information

Helpful Links

• Centers for Disease Control (CDC)
• Centers for Medicare and Medicaid Services (CMS)
• Pharmacy Resources Archive