Thanks for responding. Not sure if this would help, but I thought I'd provide some background. One of the services we offer is to set up physician offices to be their own dispensers. So, in essence, they prescribe medications which they also fill. Dispensing physicians are similar to pharmacies with the difference being they cannot dispense medications or administer injections to anyone who isn't their patient. When we credential a physician with a PBM, the PBM views them exactly the same as if they were a pharmacy and will allow medications to be adjudicated exactly the same way as if they were a CVS.
Injections, like regular meds, have an NDC that can be transmitted to and paid by a PBM. We adjudicate injections used during procedures in Dr's office all the time. However, all of our clients to this point have been physicians operating out of their offices. I'm trying to determine if an ASC is similar to a physician's office (vs a hospital which we don't do) and therefore doesn't have any special rule (legally or contractually) which wouldn't allow me to bill the NDC related to the injection under the patient's pharmacy benefit plan instead of medical.
