RESOURCES

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Press Releases

FDB Joins NCPDP’s Elite Partner Program

FDB Joins NCPDP’s Elite Partner Program

FDB Formalizes its Decades-long Support of NCPDP, with a 3-Year Commitment of Sustained Support with the Shared Goals of Patient Safety

Documents | Informational

Industry Acronym Dictionary

Industry Acronym Dictionary

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 | Informational

ePrescribing Industry Information

ePrescribing Industry Information

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

Documents

Task Group Listing

Task Group Listing

Comprehensive listing of NCPDP active Task Groups

Documents | Guides and Templates

SCRIPT Implementation Recommendations Document Version 1.57

SCRIPT Implementation Recommendations Document Version 1.57

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.

White Papers

Controlled Substance - Quantity Prescribed White Paper

Controlled Substance - Quantity Prescribed White Paper

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.

Informational

Version D Editorial Document

Version D Editorial Document

UPDATED: Version D Editorial Document - May 2021

Documents | Guides and Templates

HIPAA Information 

HIPAA Information 

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

White Papers

Qualified Medicare Beneficiary Part B Coordination of Benefit Barriers and Recommendations

Qualified Medicare Beneficiary Part B Coordination of Benefit Barriers and Recommendations

The purpose of this document is to provide electronic data solutions to current barriers for processing claims secondary to a Medicare Part B benefit for Qualified Medicare Beneficiary (QMB) Program participants that align with QMB Program requirements.

Documents | White Papers

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

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

This paper provides the healthcare industry, in particular the pharmacy sector, with historical and background information on the patient risks associated with the dosing of liquid medications and recommendations to mitigate those risks through best practices in prescription orders, prescription labeling and the provision of dosing devices.

Documents | Guides and Templates

Documents | Guides and Templates | Informational

Emergency Preparedness

Emergency Preparedness

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.

Presentations

Maximize Your Member Portal Presentation - February 4, 2021 Brown Bag Session

Maximize Your Member Portal Presentation - February 4, 2021 Brown Bag Session

Presentation given at February 4, 2021 Work Group Brown Bag Session. Discusses how to navigate NCPDP websites.

Documents | Guides and Templates

Medicare Part D

Medicare Part D

Medicare Part D and Payers Supplemental to Part D

Presentations

Focus on Pharmacy Compliance and Independent Pharmacy Credentials with resQ Presentation

Focus on Pharmacy Compliance and Independent Pharmacy Credentials with resQ Presentation

Join Dave Mammen, Account Executive, for a presentation and product demo of resQ, Pharmacy Credentialing Resource. This was previously recorded for our 2020 Virtual Product Showcase. https://www.youtube.com/watch?v=vzHeddTdcOs

Presentations

Keep Your NCPDP Standards Updated Easily with NCPDP Standards Table Data Presentation

Keep Your NCPDP Standards Updated Easily with NCPDP Standards Table Data Presentation

This video gives an overview of the NCPDP Standards Table Data. NCPDP Standards Table Data is a comma-separated, machine-readable, comma-separated data file format that can be imported into existing computer applications and databases by IT developers. https://www.youtube.com/watch?v=cA2vXdks1kw

Presentations

Mitigate Compliance Risk and Exposure for Prescription Transactions with HCIdea

Mitigate Compliance Risk and Exposure for Prescription Transactions with HCIdea

Learn more about NCPDP's HCIdea Prescriber Database. This presentation was led by Mia Ricci, National Account Executive and NCPDP's Virtual Product Showcase in November 2020. Learn more about NCPDP's HCIdea Prescriber Database. This presentation was led by Mia Ricci, National Account Executive and NCPDP's Virtual Product Showcase in November 2020. www.youtube.com/watch?v=scD-voOoWgs

Presentations

Improving Pharmacy Data Accuracy using dataQ Pharmacy Database

Improving Pharmacy Data Accuracy using dataQ Pharmacy Database

Join Dave Mammen, Account Executive, for a product demo and presentation on dataQ. This was previously recorded during our 2020 Virtual Product Showcase. https://www.youtube.com/watch?v=sb9UdFr-B-A

Presentations

RxReconn State and Federal Legislatione and Regulatory Online Tracking Tool Overview

RxReconn State and Federal Legislatione and Regulatory Online Tracking Tool Overview

Get real-time access to industry related issues with the NCPDP state and federal legislative and regulatory online tracking tool, RxReconn. Watch to learn all the benefits of RxReconn. https://www.youtube.com/watch?v=d8lJ5x_xy-I

Guides and Templates | Informational

Specialty Pharmacy Resources

Specialty Pharmacy Resources

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. View Resources at https://ncpdp.org/Specialty-Pharmacy

Documents | Guides and Templates

Background and Guidance for Using the NCPDP Standards for Digital Therapeutics

Background and Guidance for Using the NCPDP Standards for Digital Therapeutics

This document provides guidance on the use of NCPDP Standards for the ordering and fulfillment of Digital Therapeutic products and services.

Documents | Guides and Templates | Informational

White Papers

NCPDP Specialty Pharmacy Benefit Coverage Identification White Paper 

NCPDP Specialty Pharmacy Benefit Coverage Identification White Paper 

The purpose of this white paper is to highlight current challenges experienced by providers, specialty pharmacies and organizations in being able to timely and accurately identify the appropriate benefit coverage (medical or pharmacy benefit) for a specific medication being prescribed, as well as potential out-of-pocket costs to the patient at the time of care. Overall, the desired outcome of benefit identification is to provide a comprehensive benefit coverage overview electronically at the time the medication is selected and to improve a patient’s ability to begin therapy without delay. This process should be easily accessible without multiple manual steps or duplication of efforts by providers, specialty pharmacies and hubs.

Documents | Guides and Templates | White Papers

NCPDP Standards-based Facilitated Model for PDMP: Phase I and II

NCPDP Standards-based Facilitated Model for PDMP: Phase I and II

The white paper has been updated to add Phase II which supports real-time reporting and risk response in addition to Phase I functionality. The facilitated model leverages current industry technology and clinical expertise to create and/or communicate potential risks using an algorithm (e.g., risk score). The facilitated model also supports prescribers and dispensers with information to assist in making an appropriate clinical decision.

Documents | Guides and Templates

Prescription Drug Monitoring Programs (PDMP) Resources

Prescription Drug Monitoring Programs (PDMP) Resources

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

NCPDP Emergency Preparedness Guidance

NCPDP Emergency Preparedness Guidance

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

Documents

NCPDP Bylaws

NCPDP Bylaws

This document contains the rules related to the management of the National Council for Prescription Drug Programs’ internal operations.

Documents

NCPDP Standard Operating Procedures

NCPDP Standard Operating Procedures

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

Documents

Data Element Request Form (DERF)

Data Element Request Form (DERF)

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 | Guides and Templates

NCPDP Quantity Prescribed (460-ET) Implementation Timeline Guidance

NCPDP Quantity Prescribed (460-ET) Implementation Timeline Guidance

This paper offers guidance to the pharmacy industry in preparing for the implementation of CMS-0055-F, which requires the Quantity Prescribed (460-ET) field for all Schedule II drugs.

Documents | Guides and Templates

Quantity Prescribed (460-ET) Guidance

Quantity Prescribed (460-ET) Guidance

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.

Webinars

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

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

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.

Informational

Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements

Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements

CMS published a proposed rule “Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements.” The proposed rule seeks to promote value-based payments for prescription drugs and assess pharmacy benefit manager (PBM) accumulator programs and their impact on calculating average manufacturer price (AMP) and implement standards that would enhance a states’ ability to identify or limit inappropriate prescribing of opioids if a beneficiary is already receiving medication assisted treatment for substance use disorder (SUD).

Presentations

NCPDP 2020 State of the Association: Strategic Initiatives

NCPDP 2020 State of the Association: Strategic Initiatives

In this video, NCPDP President & CEO, Lee Ann Stember, gives an update on the 2019-2020 Strategic Initiatives: the Universal Patient Identifier, Powered by Experian Health UIM & NCPDP Standards™; the NCPDP Real-Time Prescription Benefit Standard; Specialty Pharmacy; and the NCPDP Standards-based Facilitators Model for PDMP, An Interoperable Framework for Patient Safety.

Webinars

The Future of Pharmacy

The Future of Pharmacy

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

Process  Overview for External Code List and Telecommunication Emergency External Code List

Process  Overview for External Code List and Telecommunication Emergency External Code List

This document provides the procedures and rules for the requests and maintenance of the External Code values that support the NCPDP approved standards.

Documents

News

NCPDP Foundation - Donate A Silent Auction Item

NCPDP Foundation - Donate A Silent Auction Item

There is still time to donate an item for the NCPDP Foundation’s “Christmas in July” Silent Auction, July 15-17. The deadline for receipt of items by the Foundation is Friday, June 26. This will allow time to present the item on the mobile bidding application for potential bidders to preview and plan their bidding. Gift cards are always popular as well as items that can be shipped easily and cost-effectively. To donate an item, please contact Debra Chavez at dchavez@ncpdp.org or 480-477-1000, Ext. 122. She will get all the information she needs from you and provide details on where to send the item. Item donations are tax deductible and the NCPDP EIN is 46-2161880. The Silent Auction is a significant fundraiser for the Foundation and important to its ability to continue funding research and pilots that prove the value of NCPDP standards and promote widespread use of them to make accessible healthcare better and safer.

Presentations

MyNCPDP Quick Start Navigation Overview Video

MyNCPDP Quick Start Navigation Overview Video

45 second video of the new Member Portal MyNCPDP.org navigation. Click Download to view.

Presentations

NCPDP.org Website Quick Start Navigation Overview Video

NCPDP.org Website Quick Start Navigation Overview Video

45 second video of the new navigation on the new NCPDP.org website. Click Download to view.

Presentations

Standards.NCPDP.org Website Quick Start Navigation Overview Video

Standards.NCPDP.org Website Quick Start Navigation Overview Video

45 second video of the new navigation for the new Standards.ncpdp.org website. Click Download to view.

Documents

NCPDP.org & Standards New Websites Quick Start Guide

NCPDP.org & Standards New Websites Quick Start Guide

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

Presentations

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

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

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

2020-21 Standardization and Work Group  Co-Chairs

2020-21 Standardization and Work Group  Co-Chairs

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

Documents

NCPDP Certification Exam Policy

NCPDP Certification Exam Policy

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

2020-2021 Work Group Co-Chairs

2020-2021 Work Group Co-Chairs

Contact listing of 2020-21 Work Group Co-Chairs

Press Releases

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

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

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

Documents | Guides and Templates

Opioid Guidance

Opioid Guidance

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 | Guides and Templates | Informational

NCPDP Processor ID (BIN)

NCPDP Processor ID (BIN)

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

Meaningful Use Resources

Meaningful Use Resources

Meaningful Use - NCPDP and Industry Resources

Documents

NCPDP Standards Matrix

NCPDP Standards Matrix

The following is a high-level overview of the latest version/release and/or the most commonly used of those standards and implementation guides, as well as NCPDP’s Data Dictionary and External Code List. Additionally, this document provides version/release/publication reference charts for approved and draft NCPDP standards/implementation guides.

Documents | Guides and Templates

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

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

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

SPAP ADAP Resources

SPAP ADAP Resources

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.

News

NCPDP Hosts Stakeholder Action Group on UPI

NCPDP Hosts Stakeholder Action Group on UPI

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

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

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.

Informational

Past Work Group Meeting Recaps

Past Work Group Meeting Recaps

Recaps of previous Work Group meetings for the past 7 years. https://standards.ncpdp.org/WG-Recaps.aspx

Documents

Billing Unit Fact Sheet

Billing Unit Fact Sheet

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

Documents | Guides and Templates

X12N 835 Payment Guidance and Related Documents - Mapping Document

X12N 835 Payment Guidance and Related Documents - Mapping Document

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 | Guides and Templates

State PMP Tracking Document

State PMP Tracking Document

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

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

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

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

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

Documents

Ballot Process and Timeline

Ballot Process and Timeline

Timeline for NCPDP ballots that are generated when the membership via a consensus driven process approves Data Element Request Forms (DERF) submitted by the industry for the creation of new NCPDP Standards or the modification of existing NCPDP Standards. ECL DERFs are NOT balloted.

Webinars

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

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

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.

News

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

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

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”).