Medi-Cal Pharmacy
All pharmacy services billed as a pharmacy claim are a benefit under Medi-Cal Rx, a Medi-Cal Fee-For-Service (FFS) program, including:
- Outpatient drugs (prescription and over-the-counter).
- Physician-Administered Drugs (PADs).
- Enteral nutritional products.
- Medical supplies.
Medi-Cal Rx does not include pharmacy services billed as a medical (professional) or institutional claim. For Physician-Administered Drugs billed as a medical claim, see Physician-Administered Drugs.
Members must obtain their prescribed drugs from a pharmacy that is in the Medi-Cal Rx pharmacy network. A list of pharmacies is available on the Medi-Cal Rx website or by calling the Medi-Cal Rx contractor at 800-977-2273.
Members need to bring their Benefits Identification Card (BIC) from Medi-Cal to the pharmacy with their prescriptions. Alliance identification cards cannot be used for Medi-Cal Rx billing.
| BIN | PCN | Group |
|---|---|---|
| 022659 | 6334225 | MediCalRx |
| Medi-Cal Rx Customer Service Center: 800-977-2273 | ||
Please note: This does not affect IHSS members. IHSS members can continue using their Alliance ID card.
The list of covered drugs for Medi-Cal Rx, or Contract Drugs List (CDL), is available on the Medi-Cal Rx website. Certain pharmacy drugs and medical supplies may require prior authorization (PA). Prior authorization requests must be submitted to Medi-Cal Rx via one of the following methods:
- Medi-Cal Rx Provider Portal.
- CoverMyMeds® (CMM).
- Fax: 800-869-4325.
- United States (US) Mail:
- Medi-Cal Rx Customer Service Center
ATTN: Provider PA Requests
P.O. Box 730
Rancho Cordova, CA 95741-0730
- Medi-Cal Rx Customer Service Center
- NCPDP P4 – Request Only.
The Medi-Cal Rx PA Request Form and additional information are available on the Medi-Cal Rx website or by calling Medi-Cal Rx at 800-977-2273.
Dispensing of a 14-day emergency supply of any medication for which delaying the dispensing would withhold a medically necessary service is permitted by Medi-Cal Rx without a prior authorization. For more information, please refer to Medi-Cal Rx website or call Medi-Cal Rx at 800-977-2273.
Medi-Cal Rx Customer Service Center
Phone: 800-977-2273, 24 hours a day, 7 days a week
TTY: Dial 711, Monday through Friday, 8 a.m. to 5 p.m.
Contact Pharmacy Department
Phone: 831-430-5507
Fax: 831-430-5851
Monday-Friday, 8 a.m. to 5 p.m.
