RESOURCES

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Webinars

From Months to Minutes – Advancements in Standards, Innovations Increasing Speed to Therapy in the Most Challenging Prescribing Workflows

6/23/2020

The presentation will describe how today’s standards and innovations are getting therapies to patients not in months, but in minutes. Efficiencies occurring in the trenches of care delivery will be discussed along with lessons learned about filling workflow gaps that still exist today.

Webinars

The Future of Pharmacy

6/9/2020

This presentation will touch on a broad range of topics including pharmacogenomics, 3D drug printing, tablet recognition, personal medication assistant, drone delivery, telepharmacy, medical marijuana, prescribing authority, reimbursement of services, tech-check-tech (TCT) and technician immunizations.

Documents | Guides and Templates

Quantity Prescribed (460-ET) Guidance

5/27/2020

The final rule CMS-0055-F published on January 24, 2020, adopts a modification of the requirements for the use of the Telecommunication Standard Implementation Guide, Version D, Release 0 (Version D.0), August 2007, National Council for Prescription Drug Programs, by requiring covered entities to use the Quantity Prescribed (460-ET) field for retail pharmacy transactions for Schedule II drugs. This change constitutes a modification to the use of the adopted standard, not a modification to the standard itself. Click for more details.

Documents

NCPDP.org & Standards New Websites Quick Start Guide

5/27/2020

Overview of what's new and navigation for the new ncpdp.org and standards.ncpdp.org websites.

Presentations

MyNCPDP Navigation Overview Video

5/27/2020

45 second video of the new Member Portal MyNCPDP.org navigation

Presentations

The New NCPDP.org Website Navigation Overview Video

5/27/2020

45 second video of the new navigation on the new NCPDP.org website

Presentations

The New Standards.NCPDP.org Website Navigation Overview Video

5/27/2020

45 second video of the new navigation for the new Standards.ncpdp.org website

Documents | Guides and Templates

HIPAA Information 

5/27/2020

This section contains information for the public about the Health Insurance Portability and Accountability Act of 1996 as it relates to the pharmacy industry.

Presentations

NCPDP 2020 State of the Association - NCPDP Website and Member Portal Review

5/21/2020

The first installment of our 2020 State of the Association IMPACT Report video series. President & CEO, Lee Ann Stember provides you with a sneak peek at the new look-and-feel of our updated website and our MyNCPDP Member Portal.

Documents

NCPDP Certification Exam Policy

5/7/2020

The Certification Exam Policy is set by NCPDP® and as such, NCPDP reserves the right to change this policy without notice. NCPDP offers computer-based testing as its testing method. You have the option to take your exam during one of NCPDP’s Quarterly Work Group Meetings, at a Kryterion Testing Center location, or you may take the exam as an Online Proctored test from your own computer with Internet access and an external webcam meeting minimum requirements. You can schedule any of the above testing delivery options at a time convenient to you.

Documents

2020-21 Standardization and Work Group  Co-Chairs

5/7/2020

Listing of the 2020-21 Work Group Co-Chairs and Standardization Committee

Documents

2020-2021 Work Group Co-Chairs

5/7/2020

Contact listing of 2020-21 Work Group Co-Chairs

Press Releases

NCPDP Issues COVID-19 Guidance For Pharmacy-Led Testing For Immediate Industry Implementation

5/4/2020

Standards-Based Information and Protocols Support Recent Authorization for Pharmacists to Order, Administer FDA Authorized COVID-19 Tests

Documents | Guides and Templates | Informational

Opioid Guidance

5/4/2020

NCPDP Recommendations for Standardized Communications to Address the Opioid Epidemic provides a short summary of issues and available guidance for implementation of opioid policies. Many states have enacted legislation that imposes some type of prescribing limits (including days supply and morphine milligram equivalency), guidance or requirements on prescriptions in order to combat the opioid crisis. Inconsistency in the implementation of these policies has presented challenges throughout the pharmacy supply chain for providing patients access to needed medication in a timely manner.

Documents | Informational

Industry Acronym Dictionary

5/1/2020

If you would like to suggest an acronym, please send an email to NCPDP@ncpdp.org with subject line "Suggested Acronym".

Documents | Guides and Templates

Meaningful Use Resources

5/1/2020

Meaningful Use - NCPDP and Industry Resources

Documents | Guides and Templates

Emergency Preparedness

5/1/2020

This page provides guidance to the pharmacy industry for resources available during a declared emergency. The intended audience is healthcare industry providers who would need resource information for eligibility and claims processing affecting displaced individuals.

Documents | Guides and Templates | Informational

NCPDP Processor ID (BIN)

5/1/2020

The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. Plans that use cards with a magnetic stripe should use the recommended American National Standards Institute (ANSI) Issue Identifier Number (IIN) for processing electronic pharmacy claims. ANSI issues IIN numbers. NCPDP issues the Processor ID Number (BIN). It is important to understand the difference between the IIN and NCPDP Processor ID Number (BIN) before applying for a Processor ID Number (BIN).

Documents | Guides and Templates

NCPDP Emergency Preparedness Information v1.7

5/1/2020

This document provides resource information for the pharmacy industry for a declared emergency

Documents | Guides and Templates

SCRIPT Implementation Recommendations

3/1/2020

This document provides requirements and best practice guidance for implementation when transmitting NCPDP SCRIPT transactions. This document also contains editorial corrections, clarifications to the NCPDP SCRIPT Implementation Guide documents.

Documents | Guides and Templates

HL7 CDA® R2 Implementation Guide:  Medication Therapy Management (MTM) Templates

3/1/2020

Two guides and templates which support the documentation and communication needs of the expanding Medication Therapy Management (MTM) services arena and the CMS Medicare Part D reporting and patient information requirements for MTM. They are to be used for the exchange of medication related information including assessment results, recommendations for modifications to medication regimens, recommendations for other services (e.g., dietary or laboratory) and the results of interventions between/among providers, payers, pharmacy benefit managers (PBMs) and patients.

Documents | Guides and Templates

Prescription Drug Monitoring Programs (PDMP) Resources

3/1/2020

Nearly all states have enacted laws to establish PDMPs, electronic databases to collect data on controlled substances dispensed or prescribed within their jurisdictions. However, the absence of business rules governing or allowing sharing of information from state to state and across pharmacies, lack of interoperability among the operational PDMPs, and variation in the timeliness of data reporting make it difficult for states and law enforcement to prevent misuse, abuse and fraud.

Documents | Guides and Templates | White Papers

NCPDP Standards-based Facilitated Model for PDMP: Phase 1

3/1/2020

In an effort to reduce patient prescription drug overdoses and drug abuse, this white paper recommends Phase 1 solutions to assist authorized healthcare providers, including prescribers and pharmacists, in making more informed clinical decisions prior to writing and dispensing medications.

Documents | Guides and Templates

SPAP ADAP Resources

2/26/2020

NCPDP, CMS, and the CMS Transaction Facilitator are continually enhancing processes to identify claims for TrOOP eligible State Pharmaceutical Assistance Programs (SPAPs) and AIDS Drug Assistance Programs (ADAPs).  Their goals are to help increase the likelihood that SPAP and ADAP claims are appropriately applied to the member’s TrOOP and that the appropriate entity is refunded or invoiced in the event of a copay/coinsurance adjustment.

Guides and Templates | Informational

Specialty Resource

2/26/2020

If you would like to participate, you can work collaboratively with colleagues and competitors alike to advance health information technology solutions through NCPDP’s consensus-building process for Specialty prescriptions. Your voice impacts your business and provides value to both you and your company.

Documents | Guides and Templates | Informational

ePrescribing Industry Information

2/26/2020

Information about electronic prescribing, standards and reference material from the industry

Informational

Hot Topics

2/26/2020

Prescription Drug Monitoring Programs (PDMP)

News

NCPDP Hosts Stakeholder Action Group on UPI

2/13/2020

NCPDP hosted a Stakeholder Action Group (SAG) last month on the heels of its announcement that 100% of the U.S. population has been successfully enumerated with a Universal Patient Identifier, Powered by Experian Health UIM and NCPDP Standards (UPI).

News

MC Task Group Seeks Input on Proposed Rulemaking: Importation of Prescription Drugs

2/13/2020

The NCPDP Maintenance and Control Education, Legislation and Regulations Task Group is seeking input and feedback from NCPDP members and non-members to review and comment on the FDA “Importation of Prescription Drugs” document. The deadline for commenting on the regulation is March 9, 2020.

Documents | Guides and Templates

X12N 835 Payment Guidance and Related Documents - Mapping Document

2/1/2020

WG45 External Standards Assessment, Harmonization and Implementation Guidance Work Group has prepared a mapping document for consistent use of the Claim Adjustment Reason Codes (CARC), Claim Adjustment Group Codes (CAGC) and NCPDP Reject Codes in the X12 835.

Documents

Task Group Listing

2/1/2020

Comprehensive listing of NCPDP active Task Groups

Documents

Billing Unit Fact Sheet

2/1/2020

Introduction to the standard and to provide essential information on the standard. Includes units for "eaches", "grams" and "milliliters"

Documents | Guides and Templates

State PMP Tracking Document

1/27/2020

All states, except Missouri, currently have a prescription monitoring program (PMP). In the absence of a national program, NCPDP Work Group 9 Government Programs created and maintains a document, which provides information on all state PMPs. Information includes the PMP name, schedules monitored, format, batch/on-line, submission methods, reporting frequency, processor, overseeing agency and contact information. This State PMP Tracking Document is updated quarterly.

News

NCPDP’s Pharmacy Outlook for 2020 Published in Chain Drug Review

1/15/2020

Chain Drug Review's special feature, "Pharmacy Outlook for 2020," published last week, includes a contributed article by Lee Ann Stember, NCPDP’s President & CEO.

Press Releases

NCPDP Announces CMS Administrator, Seema Verma, to Deliver Opening Keynote at NCPDP’s 2020 Annual Conference

1/14/2020

CMS Trailblazer Verma’s Keynote Will Address Empowering Patients and Health System Transformation to Galvanize Industry to Effect Change at NCPDP’s “Dream BIG, Act NOW” Conference

Annual Report

The Need For Speed - 2019 NCPDP Annual Report

1/1/2020

Highlights of NCPDP activities in 2019

Documents | Guides and Templates

Medicare Part D

1/1/2020

Medicare Part D and Payers Supplemental to Part D

News

100% of U.S. Population Has a UPI, Powered by Experian Health UIM and NCPDP Standards™

12/19/2019

Every person in the U.S. population, of an estimated 328 million Americans, have been assigned a unique Universal Patient Identifier, powered by Experian Health Universal Identity Manager (UIM) (https://www.experian.com/healthcare/products/identity-management) and NCPDP Standards™ (the “UPI”).

Webinars

NCPDP/HIMSS Town Hall: The Importance for the Healthcare Industry to Establish Universal Patient Identifier

12/19/2019

Learn about the Universal Patient Identifier and current legislative updates, impacts across the industry and how to will improve the healthcare experience for patients and providers.

Press Releases

NCPDP & Experian Health Announce 100% of the U.S. Population Has a Universal Patient Identifier, Powered by Experian Health UIM and NCPDP Standards™

12/18/2019

NCPDP & Experian Health Announce 100% of the U.S. Population Has a Universal Patient Identifier, Powered by Experian Health UIM and NCPDP Standards™

News

Updated Guidance for SPAPs and ADAP

12/12/2019

NCPDP recently published an updated version of NCPDP Guidance for SPAPs and ADAPs Medicare Part D Coordination of Benefits Requirements and Responsibilities.

White Papers

Controlled Substance - Quantity Prescribed White Paper

12/1/2019

(update pending) The purpose of this white paper is to provide information and guidance on the use of the Quantity Prescribed (460-ET) field to address the Schedule II controlled substances (CII’s) billing issues identified in the September 2012 OIG report and to address issues with state requirements related to CII’s for dispensing of medication in increments less than the amount prescribed.

Documents | Guides and Templates

Pharmacy and Healthcare Identification Cards - Mapping of Pharmacy ID to the ASC X12N 270/271

11/21/2019

The Excel document maps the Pharmacy ID Card data fields to the fields in the ASC X12N 270/271 transaction to give the industry guidance on where the fields should be populated should an NCPDP standard-based pharmacy ID card be presented to a prescriber who uses the X12N 270/271 standard to verify eligibility.

Guides and Templates

NCPDP Strategic National Implementation Process (SNIP)

11/21/2019

National Health Plan ID NCPDP SNIP (Strategic National Implementation Process) Committee provides HIPAA implementation guidance to the pharmacy industry. The committee answers questions, develops guidelines, provides transition assistance and develops educational material. NCPDP SNIP is a sister committee to the WEDI SNIP (Workgroup for Electronic Interchange) which is addressing HIPAA implementation for the non-pharmacy industry and receives input from the pharmacy industry via this committee.

Documents | Guides and Templates | Informational

Signature Log

11/21/2019

The Signature Log is available to members as guidance

Documents | Guides and Templates | Informational

mL Recommendation Resource Document

11/21/2019

NCPDP Recommendations and Guidance for Standardizing the Dosing Designations on Prescription Container Labels of Oral Liquid Medications call to action.

Guides and Templates

Meaningful Use Stage 2: Quality Measure Value Sets from NLM

11/21/2019

The National Library of Medicine (NLM) Value Set Authority Center (VSAC) provides downloadable access to all official versions of vocabulary Value Sets contained in Clinical Quality Measures that support Meaningful Use Stage 2. The value sets provide lists of the numerical values and individual names from standard vocabularies used to define the clinical concepts (e.g. diabetes, clinical visit) used in the quality measures. Access to the Value Set Authority Center requires a free Unified Medical Language System® Metathesaurus License.

Guides and Templates

Obtain UDI Labeler Code

11/21/2019

If you would like to obtain a labeler code for your medical device, please go to GS1 US at http://www.gs1us.org/industries/healthcare/gs1-healthcare-us-initiative/fda-udi or Health Industry Business Communications Council® (HIBCC) at http://www.hibcc.org/udi-labeling-standards/ For use within NCPDP standards, only the DI portion of the UDI will be reported, and the PI portion will be ignored. Please be aware the NCPDP Telecommunication Standard used for transmission of pharmacy transactions is currently limited to a 19-byte identifier for the product. A DI assignment of greater than 19-bytes by GS1 can be reformatted in accordance to the NCPDP Product Identifier Standard. A HIBCC DI assignment of greater than 19-bytes cannot be accommodated within the NCPDP Telecommunication Standard.

Documents | Guides and Templates

Supplemental Payer Batch N Transaction Information

11/21/2019

Supplemental Payer Batch N Transactions can be submitted to RelayHealth by SPAPs or ADAPs that are not processing claims online, are not using a switch, or have made internal adjustments to their claims outside of the pharmacy.  These batch Information Reporting transactions are forwarded to the Part D plan of record for date of service if they can be matched.

Guides and Templates

NCPDP Processor ID (BIN)

11/21/2019

The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. Plans that use cards with a magnetic stripe should use the recommended American National Standards Institute (ANSI) Issue Identifier Number (IIN) for processing electronic pharmacy claims. ANSI issues IIN numbers. NCPDP issues the Processor ID Number (BIN). It is important to understand the difference between the IIN and NCPDP Processor ID Number (BIN) before applying for a Processor ID Number (BIN).

Guides and Templates

Use of the BIN - NCPDP Processor ID

11/21/2019

The Bank Identification Number (BIN) is a term from the credit card industry. It refers to a six-digit number that is assigned to banks for electronic routing of transactions. Credit/debit cards that are involved in banking transactions contain a BIN on magnetic stripe. The term BIN is no longer supported. The number is now called an Issuer Identification Number (IIN). As of January 2017, the IIN length has changed from a 6-digit number to an 8-digit number. Existing six-digit IINs will be converted into a block of a hundred eight-digit IINs. As the majority of issuers are unlikely to need all one hundred of these, they are encouraged to return any unused eight-digit IINs to ANSI.

Guides and Templates

Issuer Identification Number - NCPDP Processor ID (BIN)

11/21/2019

The term Bank Identification Number (BIN) is no longer supported. The number is now called an Issuer Identification Number (IIN). To obtain an IIN, the American National Standards Institute (ANSI) must be contacted www.ansi.org. On the ANSI web page, enter "IIN" in the Search box. Links will appear for the registration process.

Guides and Templates

Processor Identification Number (Processor BIN) - NCPDP Processor ID (BIN)

11/21/2019

In approximately 1989 the pharmacy services sector began using electronic processing for pharmacy claims. This electronic processing of pharmacy claims meant the health plan (or their Pharmacy Benefit Manager/processor/payer on their behalf) needed a number for the electronic routing of transactions. Some health plans decided to use magnetic stripe cards, some did not. Those that use magnetic stripe cards apply to ANSI for an IIN. These numbers commonly begin with "6" as in "610014". Those health plans that did not have a business reason for creating pharmacy benefit cards with a magnetic stripe were in need of a number, because they still needed to process electronic pharmacy claims. NCPDP provides a service to those health plans that do not use magnetic stripe cards. The NCPDP Processor BIN is a six-digit sequential number we assign that begins with "0" as in "000010". We do not reuse numbers. There is a fee to obtain a number.

Documents | Guides and Templates

How to Obtain a Processor ID (BIN) - NCPDP Processor ID (BIN)

11/21/2019

Contact NCPDP Provider Services Department at 480.734.2870 or PharmacyHelp@ncpdp.org, or complete a Processor ID Application. Your number will be assigned and notification will be delivered via fax or email.

Guides and Templates

The Format of the BIN/IIN - NCPDP Processor ID (BIN)

11/21/2019

The IIN structure is defined within the international standard ISO/IEC 7812-1, Identification cards - Identification of issuers - Part 1: Numbering system. The application and registration procedures are identified in ISO/IEC 7812-2. These standards are developed by the International Organization for Standardization / International Electrotechnical Commission (ISO/IEC) Joint Technical Committee (JTC) 1, Information Technology, Subcommittee (SC) 17, Cards and personal identification, Working Group (WG) 5.

Documents

QUIC Form & Guidance

11/21/2019

Completed billing unit clarifications

Informational

Standards QUIC Form Resolutions

11/21/2019

Request for clarification forms at https://standards.ncpdp.org/Standards-QUIC-Form-Resolutions

Documents

NCPDP Collaborative Workspace  Important Instructions

11/21/2019

The NCPDP Collaborative Workspace (https://dms.ncpdp.org/) is designed for the NCPDP task groups. It is for the collaborative activity of the pharmacy services and eprescribing sectors of the industry. NCPDP uses this tool for storage of the task group working documents, information on task group calls, and task group notifications. Participants of NCPDP’s task groups agree to abide by the NCPDP antitrust policy and the expected conduct (found on the main site). The NCPDP Collaborative Workspace is a separate website and not tied to the NCPDP membership login of www.ncpdp.org

Informational

NCPDP Standards Table Data 

11/21/2019

NCPDP offers the ability to easily download the data from the Data Dictionary and External Code List (ECL). Until now, maintaining the values that support the data elements can be a daunting task for IT and claims management personnel, requiring hundreds of hours of work. NCPDP Standards Table Data provides a cost-effective solution for updating values and definitions that support the various Standards. The NCPDP Standards Table Data files are system generated from the same web-enabled NCPDP Data Dictionary and External Code List into machine-parsable raw data that can be imported into existing applications.

Documents

New Project Development Form

11/21/2019

Do you have an idea for a new project that NCPDP could address? If so, you may complete the New Project Development Form. The form must be submitted prior to the next quarterly work group meetings in order for it to be reviewed by Maintenance and Control (MC) during those meetings. It is highly recommended that the submitter be present at the MC meeting to discuss the project. If MC approves the form, the NCPDP Board of Trustees reviews and votes on it. If approved by the board, it is assigned to the appropriate work group.

Documents

Data Element Request Form (DERF)

11/21/2019

The Data Element Request Form (DERF) is the documentation used to request an addition or modification to an NCPDP standard. Anyone may submit a DERF to NCPDP along with accompanying information, including the proposed standard, implementation guide, data element dictionary, and modification log if needed. A DERF must be completed and submitted with the proper documentation prior to the next quarterly work group meetings for it to be reviewed during those meetings. The DERF is distributed to NCPDP members via the NCPDP website before the work group meeting.

Documents

NCPDP Standards Certification Non-Disclosure Agreement

11/21/2019

Before the start of the exam session, exam candidates will be asked to accept this Agreement, thereby making a commitment to behave ethically before, during and after the exam. Failure to accept this agreement will disqualify the candidate from taking the exam, and the exam fee will be forfeited.

Documents

NCPDP Certification Documentation of Special Examination Accommodations

11/21/2019

If you are seeking special accommodations for taking your exam, please have this form completed by an appropriate professional to ensure NCPDP and Kryterion are able to provide the required examination accommodations. The information you provide and any documentation regarding your disability and your need for accommodation in testing will be treated with strict confidentiality. Both forms must be returned to NCPDP within 45 days of the desired testing date.

Documents

NCPDP Certification Request for Special Accommodations

11/21/2019

If you have a disability covered by the Americans with Disabilities Act, please complete this form and the Documentation of Disability-Related Needs form so your accommodations for testing can be processed efficiently. The information you provide and any documentation regarding your disability and your need for accommodation in testing will be treated with strict confidentiality. Both forms must be returned to NCPDP within 45 days of the desired testing date.

Documents

MyNCPDP Member Portal Quick Start Guide

11/21/2019

Overview of the navigation and new features for the new Member Portal - MyNCPDP.org website.

Documents

NCPDP Standing Operating Procedures

11/21/2019

This document contains the procedures related to the structure and standards setting process of the National Council for Prescription Drug Programs

News

Now Available: SCRIPT Implementation Recommendations Document Version 1.51

11/21/2019

The SCRIPT Implementation Recommendations Document Version 1.51 is published and available to members through the NCPDP home page’s Standards Lookup in the Member Portal (https://www.ncpdp.org/home?returnurl=%2fMembers).

News

Get Real-time Access to Legislative and Regulatory News That Impacts Your Business

11/21/2019

RxReconn® is NCPDP’s state and federal legislative and regulatory online tracking tool providing subscribers with real-time monitoring of important changes in pharmacy-related legislative and regulatory activity at state and national levels.

News

NCPDP's Executive Association Tour

11/21/2019

Last week, members of NCPDP’s senior leadership team kicked-off NCPDP’s 2019 Executive Association Tour

Press Releases

NCPDP Acknowledges Founding Leadership with Lifetime Membership Award

11/21/2019

The National Council for Prescription Drug Programs (NCPDP) announced today it has awarded special recognition to its founding leaders. Benjamin D. Ward, Sr., Charles D. Pulido, R.Ph., and Edward D. Spearbeck were honored with NCPDP’s Lifetime Membership Award.

Documents | Guides and Templates | Informational

Pharmacy and Healthcare Identification Cards - Fact Sheet

11/21/2019

Guidance Document for Pharmacy and Healthcare Identification Cards-The document relates to the current NCPDP Health Care Identification Card Pharmacy ID Card Implementation Guide. The purpose of the fact sheet is to provide details about the NCPDP format and may be distributed to members and non-members. If you have any questions about the fact sheet, please contact Leslie Carr at the Council office at 480.477.1000 ext. 195

Documents | Guides and Templates | Informational

Rebate Reference Guide

11/21/2019

WG7 Manufacturer Rebates has created Reference Guide documents for the Manufacturer Rebate Standard versions v03.02 through v07.01. These documents provide guidance on a variety of manufacturer rebate scenarios and issues found in the Pharmaceutical industry and will assist in the effective implementation of these versions of the NCPDP Manufacturer Rebate Utilization, Plan, Formulary, and Reconciliation Flat File Standard.

Webinars

The Next SCRIPT Version: What is Changing, What to Expect, and What to Do About It

11/21/2019

As the industry prepares for the January 1, 2020 implementation date for SCRIPT v2017071, many ePrescribing vendors have started devising their product update plans.

News

WG1 Approves Recommendation for Next HIPAA Adopted Version of the Telecommunication Standard

11/14/2019

Members of WG1 approved the recommendation from the SNIP Committee to move forward with recommending the Telecommunication Standard Version F6 be the next HIPAA ad