Reimbursement of Assessment for Uncomplicated UTI (New Brunswick)
Effective October 1, 2021, the New Brunswick Department of Health reimburses pharmacies for an assessment by a pharmacist for uncomplicated urinary tract infections (UTIs).
For more information about this initiative, see Assessment and Prescribing for Uncomplicated Urinary Tract Infection by Pharmacists from the Government of New Brunswick.
Note: This program does not cover the cost associated with the dispensing of drugs.
Assessment of Uncomplicated UTI Fee for Service PINs
The following PINs can be used to process a Fee for Service for the Assessment of Uncomplicated UTI.
Table 1. Fee for Service for the Assessment of Uncomplicated UTI PINs
PIN | Drug Name | Cost | Purpose |
11112000 | NB PRESCRIBING UTI (UNCOMPLICATED) RSLT=RX | $20 |
Medication prescribed as a result of the Assessment of Uncomplicated UTI |
11112001 | NB PRESCRIBING: UTI (UNCOMPLICATED) RSLT=NO RX | $20 |
No medication prescribed as a result of the Assessment of Complicated UTI |
Note: A maximum of two (2) uncomplicated UTI assessment PINs of any combination can be processed per patient within 12 months.
Third Party Information
When processing an Assessment of Uncomplicated UTI Fee for Service, the following information must be entered in the patient’s 3rd Party tab on the Patient Folder. The Fee for Service claim must be billed to this plan.
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Bill Code = NI
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Carrier ID = NB
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Group ID = M
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Client ID = patient’s NB Medicare number
Processing the Fee for Service Claim for a Prescription Renewal by a Pharmacist
When creating a prescription for an Assessment of Uncomplicated UTI Fee for Service, the following information must be entered:
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Drug = a PIN listed in Table 1. Fee for Service for the Assessment of Uncomplicated UTI PINs
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Doctor = pharmacist who conducted the assessment
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Qty Auth = 1
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Qty = 1
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SIG = FEE FOR SERVICE CLAIM (or other instructions as desired – e.g. if there’s a resulting prescription, cross-reference the Rx# in the SIG for documentation and audit)
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Days Supl = 1
Prior to processing, in the Rx Detail window, ensure the cost of the prescription is $20. If not, adjust the pricing accordingly in the Pricing Details window.