1. DWC

Workers' compensation pharmacy fee schedule

Billing Units

To assist in consistent and accurate billing of pharmaceutical products, the National Council for Prescription Drug Programs (NCPDP) developed the Billing Unit Standard (BUS). The standard contains three billing units: “EA”, “ML” and “GM”.

BILLING UNIT OF “EACH” (EA) 

“EA” (each) is used when the product is dispensed in discreet units. These products are not measured by volume or weight. The Billing Unit of “EA” is also used to address exceptions where “GM” and “ML” are not applicable. Examples of products defined as “EA” include but are not limited to: 

  • Tablets 
  • Capsules 
  • Suppositories 
  • Transdermal patches 
  • Non-filled syringes 
  • Tapes 
  • Devices/Digital Therapies
  • Blister packs 
  • Oral powder packets 
  • Powder filled vials for injection
  • Kits*
  • Unit-of-use packages with a quantity less than one milliliter or gram should be billed as “one each”. For example, ointment in packets of less than 1 gram or eye drops in dropperettes that are less than 1 mL. This rule does not apply to injectable products.

NCPDP BUS specifically defines “Kits” as products that contain one of the following:

  1. at least two distinct items with different billing units
  2. one product packaged with medicated or unmedicated swabs or wipes
  3. meters packaged with test strips

BILLING UNIT OF “MILLILITER” (ML) 

“ML” (milliliter) is used when a product is measured by its liquid volume. Examples of products defined as “ML” include but are not limited to: 

  • Liquid non-injectable products of 1 mL or greater 
  • Liquid injectable products in vials/ampules/syringes
  • Reconstitutable non-injectable products at the final volume after reconstitution except when they are in powder packets 
  • Inhalers (when labeled as milliliters on the product)

BILLING UNIT OF “GRAM” (GM) 

“GM” (gram) is used when a product is measured by its weight. Examples of products defined as “GM” include but are not limited to: 

  • Creams (of 1 gram or greater) 
  • Ointments (of 1 gram or greater) 
  • Inhalers (when labeled as grams on the product)

April 2025