Medicaid, authorized as Title XIX of the Social Security Act of 1965, is the Federal/State health insurance program for low-income individuals and families. Although the Medicaid program is broadly overseen by the Centers for Medicare and Medicaid Services, each state has significant discretion to administer its own program. For example, within broad national guidelines established by Federal statutes, regulations, and policies, each state (1) establishes its own eligibility criteria; (2) determines the type and scope of services; and (3) sets reimbursement payment amounts for covered services. Additional background information about Medicaid is available at the following CMS link.

Currently, all Medicaid programs choose to offer prescription drug benefits to eligible beneficiaries. However, coverage, coding, and reimbursement for drugs varies significantly by state.

The following links provide information about Medicaid coverage and reimbursement. You will find links to each state Medicaid website, the State Medicaid Plans, as well as numerous Medicaid links from the CMS website.

• CMS Medicaid - Home
• State Medicaid Manual
• State Medicaid Plans
• Medicaid Eligibility Page
• National HCPCS Modification Process - Medicaid Only