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Louisiana Medicaid Pharmacy Coverage Update for At-Home Over the Counter (OTC) COVID-19 Diagnostic Tests Effective September 30, 2024

Date: 09/05/24

Effective September 30, 2024, the Louisiana Medicaid Pharmacy Program will end coverage for at-home over the counter (OTC) COVID-19 diagnostic tests due to the end of the Public Health Emergency (PHE) for COVID-19. Medicaid beneficiaries can access their healthcare provider for vaccines, treatments, and diagnostic testing as usual. 

Pharmacy claims submitted for at-home OTC COVID-19 diagnostic tests will deny starting October 1, 2024.

  • Denial from Gainwell (FFS Only): NCPDP rejection code 70 (Product/Service Not Covered) mapped to EOB Code 299 (Product Not Covered)
  • Denial from Magellan (MCO Only): NDPDP rejection code 70 (Product/Service Not Covered) mapped to internal code 50076 (Not a covered pharmacy benefit)

If you have questions about pharmacy claims billing, you may contact the Medicaid Pharmacy Benefit Manager, Magellan, at 1-800-424-1664.