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.
| Drug | DIN/PIN for OAT Claims | Plan Coverage | Claim Submission Requirements |
|---|---|---|---|
|
Methadose™ 10mg/mL (cherry) with direct interaction |
66999997 (PIN) |
Covered under plans: 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: 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 |
