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Pharmacy Fee Schedule
This information is effective July 1, 2008
Payment for drugs and medications, including all oral non-legend drugs, will be based on the pricing methodology described below. Refer to WAC 296-20-01002 for definition of average wholesale price (AWP). View L&I's Outpatient Formulary (163 KB PDF).
Get Help Downloading Files (files open in a new window).| Drug type | Payment method |
|---|---|
| Generic and single or multisource Brand. | AWP less 10% + $4.50 professional fee. |
| Brand with generic equivalent (substitution allowed). | AWP less 10% + $3.00 professional fee. |
| Compund prescriptions. | Allowed cost of the ingredients + $4.50 professional fee + $4.50 compounding time fee (per 15 minutes). |
Compounded prescriptions will be paid at the allowed cost of the ingredients plus a compounding time fee of $4.00 per 15 minutes and a $4.50 professional fee.
Orders for over-the-counter non-oral drugs or non-drug items must be written on standard prescription forms. These items are to be priced on a 40% margin. Prescription drugs and oral or topical over-the-counter medications are nontaxable (RCW 82.08.0281 (www.leg.wa.gov)).
