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Office of Workers' Compensation Programs
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Office of Workers' Compensation Programs (OWCP)

Pharmacy Fee Schedule

Effective May 1, 2014, the Office of Workers' Compensation Programs (OWCP) will begin calculating the maximum allowable fee for pharmacy billings of prescription drugs using a formula which differentiates between brand name drugs and generic drugs. The maximum allowable fee for brand name drugs will be 90% of the average wholesale price (AWP) plus a $4.00 dispensing fee, and the maximum allowable fee for generic drugs will be 75% of the AWP plus a $4.00 dispensing fee. This change will affect prescriptions paid under the following OWCP Programs; Division of Energy Employees' Occupational Illness Compensation (DEEOIC), and Division of Coal Mine Workers Compensation (DCMWC). The Division of Longshore and Harbor Workers' Compensation (DLHWC) will also use this formula to resolve disputes pertaining to the maximum amount payable for medication. For the Division of Federal Employees' Compensation (DFEC), the maximum allowable fee for brand name drugs will be 90% of the average wholesale price (AWP) plus a $4.00 dispensing fee, and the maximum allowable fee for generic drugs will be 70% of the AWP plus a $4.00 dispensing fee.