If a prescription (or its subsequent refill) to be paid by Medicaid exceeds the drug's maximum unit limit allowed per month, the prescriber or pharmacist must request an override for the entire
prescribed quantity. If the override is denied, then the excess quantity above the maximum unit limit is non-covered, and the recipient can be charged as a cash recipient for that amount in excess of the maximum unit limit.
In other words, for a prescription to be to be "split billed" (the maximum unit allowed paid by Medicaid and the remainder of the prescribed quantity paid by the patient), a maximum unit override must be requested by the provider,
and must be denied to be deemed non-covered. Note: A provider's failure or unwillingness to go through the process of obtaining an override does not constitute a non-covered service.