March 24, 2011 08:38 ET

NCPDP Releases Enhancements to Its Telecommunication, Manufacturer Rebate and Formulary and Benefit Standards

SCOTTSDALE, AZ--(Marketwire - March 24, 2011) - The National Council for Prescription Drug Programs (NCPDP), the leading not-for-profit pharmacy standards development organization, announced today the availability of enhancements to its Telecommunication, Manufacturer Rebate and Formulary and Benefit Standards. Every year billions of pharmacy claims are formatted using NCPDP Standards, the core framework on which the pharmacy industry operates. NCPDP's Standards provide a uniform format and layout for electronic communication of pharmacy-related data to automate and improve real-time transmission, accuracy, processing and exchange of data. The development of new standards and enhancements to existing standards are conducted using the organization's collaborative and consensus-building process.

Telecommunication Standard
The Telecommunication Standard defines the record layout for real-time prescription claim transactions, billing pharmacy transactions, certifying eligibility and prescription drug benefits,communicating detailed information defining reimbursement or denial of compensation with explanations, and concurrent drug use review. Enhancements available in the Telecommunication Standard Implementation Guide Version D.6 include:

  • New field for Controlled Substance Reporting to indicate the prescription was dispensed for use on something other than human.
  • A means for the pharmacy to submit Section 340B status subsequent to providing the prescription service.

Manufacturer Rebate Standard
The Manufacturer Rebate Standard provides a standardized format for the electronic submission of product utilization, plan membership, formulary information, market definitions, and reconciliation from Pharmacy Management Organizations (PMOs) to Pharmaceutical Industry Contracting Organizations (PICOs).The Manufacturer Rebate Utilization, Plan, Formulary, Market Basket, and Reconciliation Flat File Standard Implementation Guide Version Ø5.ØØ includes editorial corrections to the standard and the removal of fields not in use.

Formulary and Benefit Standard
The Formulary and Benefit Standard provides a standard means for pharmacy benefit payers (including health plans and pharmacy benefit managers) to communicate formulary and benefit information to prescribers via technology vendor systems. Enhancements available in the Formulary and Benefit Standard Implementation Guide Version 3.Ø include:

  • New field for co-pay specific messaging
  • Removal of outdated or not used data elements and values
  • Provides clarity as to the ability for payers to send multiple Quantity Limits (QLS), Text Messages (TMS) and/or Resource Links (RLS)
  • Consistent support of RxNorm codes
  • Provides clarity to Formulary Status values

For information on how to access the Standards or information on NCPDP member benefits, visit

Founded in 1977, NCPDP is a not-for-profit, ANSI-accredited, Standards Development Organization with over 1,600 members representing virtually every sector of the pharmacy services industry. Our diverse membership provides leadership and healthcare business solutions through education and standards, created using the consensus building process. NCPDP has been named in federal legislation, including HIPAA, MMA, and HITECH. NCPDP members have created standards such as the Telecommunication Standard and Batch Standard, the SCRIPT Standard for e-Prescribing, the Manufacturers Rebate Standard and more to improve communication within the pharmacy industry. Our data services include the NCPDP Provider Identification Number, a unique identifier of over 75,000 pharmacies, and HCIdea, "The Prescriber Identity Solution." NCPDP's RxReconn™ is a legislative tracking product for real-time monitoring of pharmacy-related state and national legislative and regulatory activity. For more information about NCPDP Standards, Data Services, Products, Educational Programs and Work Group meetings, go online at or call (480) 477-1000.

Contact Information

    Janet Cabibbo
    Amendola Communications for NCPDP
    480-664-8412 ext. 15
    Email Contact