Medicaid Pharmacy List of Reimbursable Drugs
This page contains drug information from the pharmacy file. The full list of reimbursable drugs may be viewed online or downloaded, using the link provided below. Only those prescription and non-prescription drugs which appear on the list are reimbursable under the fee-for-service Medicaid Pharmacy Program.
- The Medicaid Pharmacy List of Reimbursable drugs includes only those drugs covered under the Pharmacy benefit and is not inclusive of all covered practitioner administered drugs. Information regarding Medicaid fee-for-service covered Practitioner Administered Drugs can be found in the Provider Manuals in the Procedure Code and Fee Schedule sections for Drugs, and in Provider Communications.
- For coverage information regarding Practitioner Administered Drugs for managed care enrollees, please refer to the managed care plan's medical benefit policies and procedures.
Select the field you wish to use, then enter your search term in the "Value" field. Enter only one value at a time, using letters and/or numbers.
Instead of using an asterisk ("*") character as a wildcard to search for multiple values, simply include only the partial string for which you are searching.
Finally, select the field you would like to use when sorting your matches and click "Search" to begin searching. If you have questions or need assistance,
please let us know
To find all drugs whose NDC code contains "1234", sorted by price, you would start by selecting "NDC Code" as the field to use.
Enter "1234" as the "Value" (not "1234*"), and select "MRA Cost" as the "Sort By" field. When you click on "Search", your matches are displayed, sorted by price.
PA Code Field Values:
- PA code "0" = PA not required
- PA code "N" = PA required
- PA code "G" = PA required / may be required
- PA may be required if drug is non-preferred OR clinical criteria including FQD limits OR step therapy requirements are not met. Details regarding these limitations can be found by accessing the Preferred Drug List at: https://newyork.fhsc.com/downloads/providers/NYRx_PDP_PDL.pdf
OTC Indicator -
"Y" identifies an OTC product that are both covered by Medicaid and meet the definition of a Covered Outpatient Drug under § 1927(k)(4) of the Social Security Act.
"N" identifies an OTC products that are both covered by Medicaid, but do not meet the definition of a Covered Outpatient Drug under § 1927(k)(4) of the Social Security Act.