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APL update to Medi-Cal RX Pharmacy Benefits and Cell Gene Therapy Coverage

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The Department of Health Care Services has made an update to All Plan Letter (APL) 25-013, Medi-Cal RX Pharmacy Benefits and Cell Gene Therapy Coverage.  

This change is important to know, as it may impact how you provide services.   

  • Medi-Cal Rx now handles statewide pharmacy benefits, replacing managed-care plans for outpatient pharmacy services. 
  • This APL defines how the coverage is split, which includes Medi-Cal Rx coverings outpatient drugs/supplies and managed-care plans (MCPs) covering provider-administered drugs. 

Learn more on our website.