Wyoming Administrative Code
Agency 053 - Workforce Services, Department of
Sub-Agency 0021 - Workers' Compensation Division
Chapter 9 - FEE SCHEDULES
Section 9-6 - Fees for Pharmacy Items
Current through September 21, 2024
Pharmaceuticals must be billed with a National Drug Code (NDC) and the correct units for the NDC. See Chapter 10, and Chapter 9, Section 1 for additional guidelines.
(a) Pharmaceuticals shall be reimbursed at the lower of:
(b) Reimbursement shall be decreased by $2.50 per prescription if a paper claim is submitted unless:
(c) Over the counter items that do not have a valid NDC number shall be considered supplies and shall not be paid with an added dispensing fee. See Chapter 9, Section 4 for additional guidelines.
(d) If the pharmaceutical is a repackaged drug, as determined by the NDC for the product dispensed, reimbursement shall be calculated per Section 6(a) using the AWP of the lowest cost therapeutic equivalent product.
(e) If a pharmaceutical intended for outpatient use is dispensed through the office of a medical care provider, reimbursement will be calculated per Section 6(a) - (d), equivalent to the reimbursement provided to a retail pharmacy.