US · guidance
CMS Pub. 100-04, ch. 20, § 110.1.1
Requirements for Implementing the NCPDP Standard
Retail pharmacies will be identified by a value of A5 in the specialty code as received by
the National Supplier Clearinghouse. Only DME MAC suppliers with an A5 specialty
code may use the NCPDP standard. The DME MACs, their EDI submitters, and their
other trading partners are required to transmit the NDCs in the NCPDP standards for
identification of prescription drugs dispensed through a retail pharmacy. NDCs replace
the drug HCPCS codes for retail pharmacy drug transactions billed to DME MACs via
the NCPDP standards.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
4dba6144d53a88814fc4b0801b5dbf7800d524940295a6bcedf72a10a402e51f
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