Billing Unit Requests

NCPDP developed and maintains the Billing Unit Standard (BUS) – the “billing quantity language” for pharmacy transactions. The guiding principle behind the BUS is that the quantity for every drug product can be described as a number of "eaches" or "grams" or "milliliters."

Drug Manufacturers

The use of a standard for the assignment of billing units is critical in most aspects of drug claims-from the initial submission of a claim and drug use reviews through the back-end rebates process. As new products and packaging are developed, it is important that manufacturers be aware of and stay consistent with the NCPDP Billing Unit Standard. NCPDP Work Group 2 (WG2) Product Identification has developed a fact sheet that provides a brief description of the standard. Manufacturers should use the Billing Unit Decision Tree to help answer questions or determine correct billing unit assignments. It may also be helpful to consult the QUIC Form Resolutions for difficult-to-classify products that have been clarified.

Package Size Discrepancies

Sometimes there are discrepancies among the drug compendia on different methods/policies for defining package size. This can result in billing and adjudication errors. NCPDP’s WG2 compiled a list of NDCs with package size discrepancies across the compendia, reviewed and aligned them with the billing unit standard. WG2 continues to review package size discrepancies brought to its attention. Please send package size discrepancies to Terry Fortin at tfortin@ncpdp.org.

Billing Unit Decision Tree
Billing Unit Fact Sheet
QUIC Form and Guidance
QUIC Form Resolutions

QUIC Form Requests

If a product cannot be readily classified, manufacturers can submit a Quantity Unit Information Communication (QUIC) form for clarification. QUIC forms help to:

  • Ensure the integrity of the billing standard.
  • Serve as a mechanism for the pharmacy community and NCPDP to communicate/document issues and resolutions which are billing unit related.
  • Guide the pricing compendia in data consistency.
  • Provide a mechanism for the work group to track issues and communicate to the industry that concerns will be addressed timely and efficiently.

The basic process for a QUIC Form is:

  • Submit an electronic QUIC form to the WG2 liaison office with accompanying information. Each QUIC form must be received thirty (30) days before the next work group meeting is scheduled.
  • Upon receipt, the WG2 liaison will notify the submitter of the assigned QUIC form number and provide the date that it will be reviewed.
  • The copy of the QUIC form request is sent to the co-chairs of WG2. The co-chairs will coordinate research on the request and the requestor will be contacted and the manufacturer (if different) directly with any questions. It is also placed in the members only area of the website.
  • Work groups during quarterly meeting review the QUIC form. We strongly encourage submitters to attend the meeting to discuss your request.
  • After the work group meeting each QUIC form requestor will receive an email from the WG2 liaison that will provide information on their request.