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National Drug Code (NDC) Billing Requirements

Date: 11/24/25

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 apropriate 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.