Compounded prescription PINs

Last updated on April 4, 2024

Before submitting requests for PharmaCare coverage of ANY compound, pharmacists must ensure that the request complies with the Compounded Prescriptions Policy in Compounded Prescriptions — Section 5.13, PharmaCare Policy Manual. Any amounts paid out by PharmaCare for compounds that do not comply with this policy are subject to recovery.

On this page:

Press Ctrl+F to search a table for a compound. For exceptional coverage of a compound not listed here, please refer to the Compounded Prescriptions — Section 5.13, PharmaCare Policy Manual.

All compounds—whether a PharmaCare benefit or not—must be submitted in PharmaNet using the appropriate PIN.

If you are unsure which PIN to use for the prescribed compound or if the patient meets criteria, please contact the PharmaNet HelpDesk before submitting the claim on PharmaNet.


Compounding fee schedule

The table below establishes maximum fees for both eligible compounds and for compounds approved via Special Authority. The inclusion of a fee for a particular type of compound in the schedule below, therefore, does not necessarily confer coverage.

The table below establishes maximum fees for both benefit compounds and for compounds approved via Special Authority, which would otherwise be a non-benefit. The inclusion of a fee for a particular type of compound in the schedule below, therefore, does not necessarily confer benefit status. 

Compounding fee schedule
Compound
Maximum Allowable Compounding Fee
Oral solutions $20.00
Oral suspensions $20.00
Capsules $0.30 per capsule
Suppositories $40.00 for a minimum 10-day supply. Prescriptions for less than 10-day supply are prorated to maximum $4.00 per day.
Oral lozenges $40.00 for a minimum 10-day supply. Prescriptions for less than 10-day supply are prorated to maximum $4.00 per day.
CADD injections $20.00
Sterile IV, IM, SC injections $20.00
Intrathecal injections $40.00
Creams/ointments/lotions < or = 250 g/mL $15.00
Creams/ointments/lotions > or = 251 g/mL $20.00
Sterile eye drops, preservative free $30.00

Eligible PINs

All eligible compound PINs have criteria. Additionally, compounds containing active ingredients that are subject to Special Authority will require Special Authority approval.

Eligible PINs index:

Oral suspensions

The maximum compounding fee for oral suspensions is $20 per compound. For the list of eligible bases, see below this table.

Eligible bases for compounded oral suspensions

Eligible bases for compounded oral suspensions include—but are not limited to—the following:

  • *fixed oil suspension
  • *methylcellulose 1% gel
  • *methylcellulose suspension
  • Ora Blend® (regular and SF) or equivalent
  • Ora Sweet® (regular and SF) or equivalent
  • oral base SF
  • oral mix (regular and SF)
  • oral mix dry alka SF
  • oral suspend
  • oral syrup (regular and SF)
  • *simple syrup
  • sodium bicarbonate stock solution (not commercial injection)
  • *sorbitol solution USP 70%
  • syrup (flavored, oral vehicle)
  • syrup SF (flavored, oral SF vehicle)
  • water (demineralized, distilled, *preserved or purified)

SF = sugar-free

* = either in-store made (stock solution) or commercially available product

If a vehicle or base is not listed above, please contact the PharmaNet Help Desk to determine whether the base is eligible for coverage before submitting a claim.

Note: Stock solutions are not eligible for a separate compound fee. Please see Maximum Allowable Costs and Fees, Stock Solutions.

Dermatologicals

Dermatological compounds may be processed under a PIN from the table below only if

  • It does not duplicate a commercial product
  • The eligible active ingredient(s) are compounded into an eligible medicated or non-medicated base. Compounds in transdermal bases are not an eligible PharmaCare benefit. For eligible bases, see list below this table
  • The compound criteria have been met
  • If any active ingredient requires Special Authority and an approval has been granted  

Topical antifungals and retinoic acid also require a current Special Authority for the active ingredient, with the exception of an eligible topical antifungal for a Palliative Care registered patient (Plan P).

The maximum compounding fee for dermatologicals is $15 up to 250 gm/mL, and $20 over 250 gm/mL.

 Eligible bases for compounded dermatologicals

 Eligible non-medicated bases include—but are not limited to—the following:

  • Aquaphor™
  • Aveeno® cream or lotion (SPF-free and not anti-itch or anti-aging)
  • Barriere™ cream
  • Cetaphil® cream or lotion
  • Cera-Ve® cream, lotion or ointment (SPF-free)
  • Cliniderm™ cream or lotion
  • cold cream
  • Complex 15™ cream or lotion
  • Dermabase™
  • Dilusol™
  • Dormer™ cream or lotion (SPF-free)
  • Duonalc™
  • emollient cream
  • emulsifying ointment
  • Eucerin™ anhydrous, cream, lotion or ointment (SPF-free and not anti-aging)
  • Glaxal Base™ 
  • Glysomed® cream or lotion
  • hydrophilic petrolatum or hydrophilic petrolatum 25% water (aqueous)
  • Intrasite Gel™
  • lanolin
  • Lubriderm® (SPF-free)
  • Medi-Derm™ cream base
  • mineral oil
  • Neutrogena® (SPF-free and not T/gel, sunscreen or anti-aging)
  • Spectro® cream
  • Spectro Jel™ (cleaner and blemish-prone cleanser)
  • urea cream or lotion (including Urisec®)
  • vanishing cream
  • Vaseline™ jelly
  • zinc oxide (SPF-free) topical cream or ointment (including Desitin®, Ihle's Paste, Infazinc® and Zincofax®)

For more information about eligible bases, please contact the PharmaNet Help Desk. 

Mouth rinses

 
Mouth rinses
Special Authority required
PIN
corticosteroid with nystatin, diphenhydramine and tetracycline Yes, except for Plan P registered patients 22123332
corticosteroid with nystatin, diphenhydramine, tetracycline and lidocaine Yes, except for Plan P registered patients 22123333
corticosteroid with nystatin and diphenhydramine Yes, except for Plan P registered patients or prescriptions written by an exempted prescriber. 22123334
corticosteroid with nystatin and lidocaine, with or without glycerin Yes, except for Plan P registered patients 22123335

Intrathecal analgesics—palliative

Repackaging a prescribed benefit injectable analgesic, or a Special Authority approved medication for intrathecal administration is only a benefit compound under a PIN from the table below when a patient is registered under the PharmaCare Palliative Care Drug Plan (Plan P).

 
Intrathecal Analgesics—Palliative
Compound criteria
Special Authority required
PIN
narcotic Yes No 22123299
non-narcotic Yes No 22123300
narcotic and non-narcotic Yes No 22123301

CADD injections—palliative

Repackaging a prescribed injectable benefit analgesic into a continuous ambulatory delivery device (CADD) pump is only a benefit compound under a PIN from the table below when a patient is registered under the PharmaCare Palliative Care Drug Plan (Plan P).

 
CADD Injections—Palliative
Compound criteria
Special Authority required
PIN
non-narcotic Yes No 22123287
narcotic Yes No 22123288
controlled Yes No 22123371

Medical assistance in dying (MAiD)

 
Medical Assistance in Dying (MAiD)
Special Authority required
PIN
phenobarbital/chloral hydrate/morphine sulphate suspension No 88000002
secobarbital suspension No 88000003

Preservative-free eyedrops

Preservative-free sterile eye drops may only be processed under a PIN from the table below when an ophthalmologist has documented the patient’s allergy to specified preservative(s) in commercially available eye drops on the compound prescription.

The maximum compounding fee for eye drops is $30.

Other compounds

* Coverage is provided for quinidine. Quinidine may be confused with clonidine, quinine.


Non-benefit PINs

For all non-benefit compounds, use the appropriate PINs in the table below.

If you are unsure whether a compound may be processed under an eligible PIN, please contact the PharmaNet HelpDesk before submitting the claim on PharmaNet.


Discontinued compound PINs

PharmaNet records show the following PINs are still being utilized to submit compound claims. Please refer to the Compounded Prescriptions Policy for eligibility requirements and the eligible PIN list for a suitable replacement.

If there isn’t an eligible PIN for the compound being prepared (where the patient meets the compound criteria) and there is no suitable non-benefit PIN from the table above, please contact the PharmaNet HelpDesk.