California
Provider Communications
Pharmacy services to be fee-for-service benefit
As previously reported, the Department of Health Care Services (DHCS) will transition all pharmacy services for Medi-Cal Managed Care (Medi-Cal) to a fee-for-service benefit. The Medi-Cal pharmacy benefits and services administered by DHCS in the fee-for-service delivery system is identified collectively as Medi-Cal Rx.
Beginning January 1, 2022, the following services (administered or dispensed by pharmacy) will be carved out of Medi-Cal and transitioned to Medi-Cal Rx:
- Covered outpatient drugs, including physician administered drugs (PADs) and patient administered contraceptives
- Medical supplies (insulin syringes and pen needles, lancets, diabetic test strips, inhaler spacers)
- Enteral nutritional products
- Home infusion therapies
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Medi-Cal Rx processing information for providers |
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Phone number |
800-977-2273 |
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Email/chat |
Available at www.Medi-CalRx.dhcs.ca.gov |
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Beneficiary ID |
Use either the 14-character beneficiary identification number located on the front of the Benefits Identification Card (BIC) or the nine-character Client Index Number (CIN) corresponding to the first nine characters of the beneficiary identification number. Please note that same-day, new Medi-Cal enrollments will require the 14-character BIC for services rendered on that enrollment day.
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Claims PAs Eligibility (E1) |
BIN: 022659
PCN: 6334225 |
Featured In:
November 2021 Anthem Blue Cross Provider News - California