National Drug Code (NDC) Billing Requirements

Date: 12/01/25

When submitting claims for physician-administered drugs, biologics, and drug-related revenue codes, you must include the following details on all applicable claims:

• National Drug Code (NDC):
  • Must be 11 digits in the 5-4-2 format.
  • Add leading zeros if necessary to meet the required format.
• Quantity and Unit of Measure:
  • Report the quantity along with the appropriate unit of measure (e.g., GR, ML, UN, F2).
  • Decimals are allowed when reporting quantities.

Important Notes:

• NDC is required for all J-codes.
• NDC is not required for G-codes, P-codes, or routine immunization drug codes.