Medicaid Moving to New Pharmacy Reimbursement Methodology

The Centers for Medicare and Medicaid Services will conduct a voluntary national survey of pharmacies to support development of a new Medicaid methodology for reimbursing pharmacies.


The Centers for Medicare and Medicaid Services will  conduct a voluntary national survey of pharmacies to support development of a new Medicaid methodology for reimbursing pharmacies.

The National Average Drug Acquisition Cost “is a new pricing benchmark that will be based on the average costs that pharmacies pay to acquire Medicaid outpatient drugs,” according to a notice available here on March 1 and being published March 2 in the Federal Register. “It is intended to provide states with a more accurate reference price to base reimbursement for prescription drugs and will be based on drug acquisition costs collected directly from pharmacies through a nationwide survey process.”

CMS expects to randomly survey pharmacies on a monthly basis, with a total of 30,000 annual responses.

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