OAT PINs and DINs

The table below provides appropriate PINs and DINs for PharmaCare claims for opiate agonist therapy (OAT) treatments for opioid use disorder. PINs listed are for OAT claims only.

Interaction Fees

For all eligible direct interaction OAT claims, PharmaCare pays an interaction fee to pharmacies that are:

  • enrolled in the Methadone Maintenance Sub-Class; and
  • dispensing methadone with direct interaction

Plan B claims are excluded from interaction fees. Eligible claims include those for Fair PharmaCare beneficiaries who have not met their deductible.

Pain Indications

Many of the drugs listed below may be prescribed for pain. If a prescription is for pain, enter the transaction in PharmaNet with the correct DIN.

Do not use OAT PINs for pain indications.

 

Quick Reference Table for OAT PINs and DINs
Drug DIN/PIN for OAT Claims Plan Coverage Claim Submission Requirements

Methadose™ 10mg/mL (cherry)

with direct interaction

66999997 (PIN)

Covered under plans:
B, C, G, P, W and Fair PharmaCare.

100% of the cost of methadone for maintenance and associated dispensing fees are covered for persons born before 1940, even if they are not registered for Fair PharmaCare.

Maximum one dispensing fee and one interaction fee per patient per day.

 

Claim quantity must be submitted as total mLs.

SIG must include dose in mg & mL (e.g. Take 5mLs (50mg) once daily.)

SIG must include the start and end dates of the prescription.

Carries must be claimed as single multiple-day supply for drug cost, plus a single dispensing fee. A single interaction fee will be paid for the first witnessed dose.

Split doses must be claimed as a single multiple-dose claim for drug cost, plus a single dispensing fee.

A single interaction fee will be paid for the first witnessed dose.

Methadose™ 10mg/mL (cherry)

delivery

with direct interaction

66999999 (PIN)

Methadose™10mg/mL Sugar- Free

with direct interaction

67000001 (PIN)

Methadose™10mg/mL Sugar-Free

delivery

with direct interaction

67000003 (PIN)

Metadol-D® 10mg/mL (unflavoured)

with direct interaction

67000005 (PIN)

Metadol-D® 10mg/mL (unflavoured)

delivery

with direct interaction

67000007 (PIN)

Methadose™ 10mg/mL (cherry) 

delivery

without direct interaction

67000000 (PIN)

Covered under plans:
B, C, G, P, W and Fair PharmaCare.

100% of the cost of methadone for maintenance and associated dispensing fees are covered for persons born before 1940, even if they are not registered for Fair PharmaCare.

Claim quantity must be submitted as total mLs.

SIG must include dose in mg & mL (e.g. Take 5mLs (50mg) once daily).

SIG must include the start and end dates of the prescription.

Carries must be claimed as single multiple-day supply for drug cost, plus a single dispensing fee. 

Split doses must be claimed as a single multiple-dose claim for drug cost, plus a single dispensing fee. 

Methadose™ 10mg/mL (cherry)

without direct interaction

66999998 (PIN)

Metadol-D® 10mg/mL (unflavoured)

without direct interaction

67000006 (PIN)

Metadol-D® 10mg/mL  (unflavoured)

delivery

without direct interaction

67000008 (PIN)

Methadose™10mg/mL Sugar-Free

without direct interaction

67000002 (PIN) Special Authority coverage required under plans B, C, G, P, W and Fair PharmaCare. 

Methadose™10mg/mL Sugar-Free

delivery

without direct interaction

67000004 (PIN)

 Kadian® slow-release     oral morphine 10mg   capsule

22123349 (PIN)

Covered for OAT under plans B, C, G, P, W and Fair PharmaCare.

No interaction fee paid for witnessed ingestion.

Submit using PharmaCare PINs if for OAT.

Claim quantity must be submitted as the number of capsules.

SIG should include start and end dates as best practice (not mandatory.)

 Kadian® slow-release     oral morphine 20mg   capsule

22123346 (PIN)

 Kadian® slow-release     oral morphine 50mg   capsule

22123347 (PIN)

 Kadian® slow-release     oral morphine 100mg   capsule

22123348 (PIN)

Buprenorphine/Naloxone SL 2mg/0.5mg generics

ACT 02453908

Covered under plans B, C, G, P, W, and Fair PharmaCare.

No interaction fee paid for witnessed ingestion.

Claim quantity must be submitted as the number of tablets.

SIG should include start and end dates as best practice (not mandatory.)

 

PMS 02424851

 Buprenorphine/Naloxone   SL 8mg/2mg generics

ACT 02453916
PMS 02424878
 Suboxone®   Buprenorphine/Naloxone   2mg/0.5mg SL 02295695

Suboxone® is a partial benefit under plans B, C, G, P, W, and Fair PharmaCare.

No interaction fee paid for witnessed ingestion.

 Suboxone®   Buprenorphine/Naloxone   8mg/2mg SL 02295709
 Suboxone®   Buprenorphine/Naloxone   12mg/3mg SL 02468085

Exceptional Special Authority coverage required under plans B, C, G, P, W and Fair PharmaCare.

No interaction fee paid for witnessed ingestion.

 Suboxone®   Buprenorphine/Naloxone   16mg/4mg SL 02468093