Fee-For-Service Billing Information for Naloxone
Generic Naloxone - FFS covers generic naloxone without prior authorization. Claims for naloxone should be submitted via standard billing processes.
Nasal Atomization Device - FFS will make payment for the nasal atomization device used to administer naloxone intranasally. Providers may submit pharmacy claims for the nasal atomization device using NDC 06011-2313-06.
Evzio (Naloxone Auto-Injector) - Evzio requires prior authorization in the FFS program. The MA Fee-for-Service Program Pharmacy Call Center accepts requests for prior authorization at 1-800-537-8862 Option 1, between 8 a.m. and 4:30 p.m., Monday through Friday. Once a prior authorization has been approved, providers can submit claims via standard billing processes.
Pharmacies will need to contact each MCO individually to obtain information about their billing procedures.
See Department of Health website for more information on Naloxone Standing Order.