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Attn Pharmacy Owners/Pharmacists-in-Charge: NLPDP Bulletin – Flu Shot Billing

The following bulletin is now available on the NLPDP bulletin site. 
 
Reimbursement of Public Flu Vaccinations under the Newfoundland and Labrador Prescription Drug Plan (NLPDP) – 2020/21 Flu Season
 
 
Dear Provider:
 
For the 2020-21 flu season authorized pharmacies can claim an enhanced pharmacy services fee for delivering an approved flu vaccine from the public vaccine stockpile to residents of Newfoundland and Labrador holding a valid MCP card.
 
Pharmacies that have already received flu vaccine stock can submit claims for NLPDP beneficiaries right away. For non-NLPDP residents, claims that were submitted today and rejected can be resubmitted tomorrow, in addition claims can also be held and submitted tomorrow.
 
Reimbursement
 
The NLPDP will reimburse a Special Services Fee of $13.00 for each flu vaccine provided. This will be the only fee paid – no drug cost or dispense fee will be paid for flu vaccines.
 
Pharmacists may only provide injectable flu vaccines to beneficiaries aged 5 and over. If a claim is submitted outside of these guidelines then the claim will reject with Response Code MU (Age Precaution Indicated).

Claiming

Claims for the Flu Vaccine Fee must be submitted as follows:
  • DIN: As per the public vaccine provided.
  • Prescriber Reference ID: 16
  • Prescriber: Use the NLPDP Billing number of the pharmacist doing the consultation
  • Days Supply: 1
  • Quantity: 1
  • Drug Cost: 0.00
  • Professional Fee: 0.00
  • Compound Fee: 0.00
  • Special Services Fee (SSF): 13.00
 
NLPDP Beneficiary Co-Payments
 
There will be NO client co-payment required for claims for the provision of flu vaccines to NLPDP beneficiaries.
 
NLPDP Coordination of Benefits
 
There will be no coordination of benefits for flu vaccine claims. If the claim rejects with Response Code C6 (Patient has other coverage) please resubmit the claim with Intervention Code DB.



Pharmacists' Association of NL
85 Thorburn Road, Suite 203
St. John's, NL  A1B 3M2
Phone: 709.753.7881
Email: email@panl.net
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