F6 Client Hub

While impacts vary by client, commonly affected areas may include:

• Billing and eligibility file layouts
• Pharmacy claims files and extracts
• Data warehouses and reporting tools
• Vendor integrations (e.g., billing files, prior authorization, eligibility)
• Member or provider-facing reports and communications 
   

Clients are responsible for assessing their specific internal impacts.

Possibly. If your internal systems send, receive, validate, transform, store, or trend pharmacy transaction fields affected by F6, updates may be required. Clients should review Express Scripts‑provided documentation to determine applicability.

Yes. Clients should confirm that any external vendors consuming pharmacy transaction data (e.g., reporting, analytics, prior authorization) are aware of F6 requirements and timelines. Early vendor engagement helps reduce implementation risk.

The industry is moving from six-digit Bank Issuer Numbers (BINs) to eight-digit Issuer Identification Numbers (IINs) as part of the HIPAA-mandated NCPDP Telecommunication Standard Version F6 (F6). BINs/IINs help route pharmacy claims for processing, and the change supports consistent routing and long-term availability of routing values.

Re-carding is not required, but ID cards (digital and physical) may be updated over time to display an eight-digit IIN in place of the six-digit BIN. In most cases, the IIN will appear where the BIN appears today, labeled “IIN” or “Issuer Identification Number,” with two zeros added to the end of the current BIN.

• Example: BIN 003858 becomes IIN 00385800.

Claim submission depends on the transaction version and the implementation timeline. During the transition, an ID card display change does not automatically mean the pharmacy should change claim submission. Express Scripts and other PBMs will provide NCPDP-approved guidance to pharmacies on what to submit and when as we transition to F6.

No. Express Scripts does not plan to reissue physical ID cards as part of the F6 transition. However, starting January 1, 2027, any new or reissued cards should reflect the updated IIN and 8-digit values.

Yes. As part of the industry transition to NCPDP Telecommunication Standard Version F6, certain billing and eligibility files may require updates to support new or expanded data elements. Impacts vary by client depending on current file formats, downstream systems and vendor integrations.

F6 does not change the purpose of billing or eligibility files, but it may affect:

• Data field lengths or formats
• The availability of new or enhanced data elements
• Alignment with updated industry standards

These changes are designed to support regulatory compliance and future‑ready data exchange.

No. Impact depends on factors including:

• The file formats you use today
• Whether files are managed internally or by third‑party vendors
• How downstream systems consume pharmacy data

Your account team will help assess your impact and timing based on your specific setup.

Yes. Express Scripts will provide updated documentation, guidance, and timelines through established client resource channels to support billing and eligibility file updates as needed. This information will be shared in advance of required testing and transition milestones.

Clients are encouraged to:

• Inventory billing and eligibility files
• Identify internal teams and vendors responsible for those files
• Monitor upcoming F6 communications from Express Scripts

Early awareness helps ensure sufficient time for planning, testing and vendor coordination.

Yes. Where applicable, Express Scripts will offer testing support and validation opportunities to help ensure billing and eligibility files function as expected as part of the F6 transition. Specific testing details will be provided closer to implementation milestones.

Clients should plan to share Express Scripts–provided information about file transitions and any related documentation with their vendors once available. If needed, please coordinate with your Account team representative to facilitate vendor conversations and clarify expectations related to F6 readiness.

Express Scripts will conduct testing on select client benefits as part of our Claim Adjudication Data Flow (CADF) testing efforts. For clients with self-service testing capabilities, the ability to perform validation activities will also be available, where applicable, upon release.

As testing progresses, updates may be issued due to external guidance or defect resolution. When applicable, updates will include:

• Clear versioning
• Documentation of changes
• Identification of breaking versus non‑breaking updates

Retesting expectations

Clients are encouraged to leverage the F6 readiness checklist made available by Express Scripts to assess progress across governance, technology, vendors and testing. Account teams are available to help review readiness status and next steps.

A centralized intake process will be provided for submitting F6‑related questions, issues, or clarifications. Items will be triaged and addressed through established program governance and communications.

Additional F6 resources, timelines, documentation, and readiness materials will be shared through established Express Scripts client communication channels as they become available. If you have specific F6-related questions, work with your account manager.