Identifying Medicaid Payment for Physician Administered Drugs (CMS-10215)

OMB 0938-1026

OMB 0938-1026

Section 6002 of the Deficit Reduction Act (DRA) of 2005 added provisions under section 1927 of the Social Security Act to require physicians in their offices and hospital outpatient settings or other entities (e.g., non-profit facilities) to collect and submit the drug National Drug Code (NDC) numbers on Medicaid claims to their State in order for Federal Financial Participation to be available for these drugs. We estimate that there are 20,000 physicians in their offices, hospital outpatient settings or other entities (e.g., non-profit facilities) concentrating in the specialties of oncology, rheumatology and urology will be required by their State Medicaid Programs to collect and submit Healthcare Common Procedure Coding System (HCPC) J drug code data match with NDC numbers. CMS released a letter to State Medicaid Directors on July 11, 2006 to explain the requirements of the State collection and submission of the drug NDC numbers on Medicaid claims. This collection is also associated with CMS-2238-FC Medicaid Program: Prescription Drugs published under Volume 72, Number 136, Tuesday, July 17, 2007, Rules and Regulations (RIN 0938-AO20). The requirements for this collection are codified under 42 Code of Federal Regulations section 447.520 Federal Financial Participation: Conditions relating to physician administered drugs.

The latest form for Identifying Medicaid Payment for Physician Administered Drugs (CMS-10215) expires 2021-07-31 and can be found here.

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