Due to COVID-19, CMS will continue to exercise discretion, allowing pharmacists to authorize emergency fills when prescribers are not available to provide refill renewal prescriptions, when consistent with state emergency declarations.
If a prescriber is unavailable to refill a patient’s prescription, a pharmacist may authorize the refill. This emergency exception can only be used when previously authorized by a prescriber. Pharmacy claims should be submitted using a Type 1 NPI-Individual. However, if the pharmacist does not have a Type 1 NPI, CMS is allowing pharmacists to submit the pharmacy’s Type 2 NPI-Organization on the claim.
When submitting a Type 2 NPI, pharmacies need to submit the following:
Field Name | NCPDP Field Name |
420-DK | SUBMISSION CLARIFICATION CODE |
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