Oral suspensionsĮligible bases for compounded oral suspensionsĮligible bases for compounded oral suspensions include-but are not limited to-the following: For the list of eligible bases, see below this table. The maximum compounding fee for oral suspensions is $20 per compound. Additionally, compounds containing active ingredients that are subject to Special Authority will require Special Authority approval. Prescriptions for less than 10-day supply are prorated to maximum $4.00 per day.Īll eligible compound PINs have criteria. The inclusion of a fee for a particular type of compound in the schedule below, therefore, does not necessarily confer benefit status. The table below establishes maximum fees for both benefit compounds and for compounds approved via Special Authority, which would otherwise be a non-benefit. The inclusion of a fee for a particular type of compound in the schedule below, therefore, does not necessarily confer coverage. The table below establishes maximum fees for both eligible compounds and for compounds approved via Special Authority. If you are unsure which PIN to use for the prescribed compound or if the patient meets criteria, please contact the PharmaNet HelpDesk before submitting the claim on PharmaNet. For exceptional coverage of a compound not listed here, please refer to the PharmaCare Policy Manual, section 5.13, Special Authority for non-benefit compounds.Īll compounds-whether a PharmaCare benefit or not-must be submitted in PharmaNet using the appropriate PIN. Press Ctrl+F to search a table for a compound.
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