Make your everyday journaling more personal, private, and stylish with this matte hardcover journal. Available in 5.75"x8", with 150 lined pages, these sturdy hardcover journals are fully customizable on the front and on the back covers. The matte laminate coating on the cover will make them stay true to your personal style.
.: Full wraparound print .: 150 lined pages (75 sheets) .: Matte finish .: Casewrap binding .: Note: 0.5"x0.5" production barcode visible on the back cover
State Requirements
Eligible Medications: Contraceptive pills, patches, and vaginal rings.
Prescription Limitations: Up to 12 months of refills. Follow-up required after two years.
Age Restrictions: Patients must be 18 years or older.
Documentation Requirements: Maintain patient records for 7 years; comply with HIPAA regulations.
Training Requirements: Completion of state-mandated courses for prescribing and patient counseling.
Reimbursement Details
Eligibility:
Medicaid Enrollment - Confirm Medicaid Eligibility for covered contraceptive services.
Pharmacists must be licensed in Utah and enrolled as a provider with Utah Medicaid to receive reimbursement.
Pharmacists dispensing self-administered hormonal contraceptives under a standing order are eligible for an annual consultation fee reimbursement of up to $20.
Billing Codes:
Use CPT Code 99401 (preventive counseling) with FP Modifier for family planning services. Pharmacy claims for self-administered hormonal contraceptives must include one of the following diagnosis codes:
Z30.011 – Encounter for initial prescription of contraceptive pills
Z30.015 – Encounter for initial prescription of vaginal ring hormonal contraceptive
Z30.016 – Encounter for initial prescription of transdermal patch hormonal contraceptive
Dispensing Fee:
Pharmacists can receive a dispensing fee for prescriptions billed under Medicaid when using their Medicaid-registered individual NPI.
Submission Process:
Submit claims via Utah Medicaid PRISM system.
Electronic Submission: All claims must be submitted electronically using the National Council for Prescription Drug Plan (NCPDP) Version D.0 standard.
Claims are processed in real time through the point-of-sale (POS) system.
NPI Requirement: Claims must include the prescriber’s valid National Provider Identifier (NPI). Claims with incorrect or missing NPIs will be denied or subject to recoupment.
