Reminder: What you need to know about billing specialty pharmacy drugs

We want to remind you that specialty pharmacy drugs shouldn’t be billed by both the specialty pharmacy and physician. 

When physician-administered drugs are ordered from the specialty pharmacy and shipped to the physician for administration, the specialty pharmacy submits the claim for the drug under the medical benefit. The physician should only bill for the administration of the drug. 

If the specialty drug is billed by both the specialty pharmacy and physician, the physician’s claim may be denied.