The state Department of Health Care Services (DHCS) carves out all prescription benefits from Managed Care Plans under a program called Medi-Cal Rx. All pharmacy claims should be submitted directly to the state via its pharmacy benefit manager (PBM), Magellan Medicaid Administration, Inc.
For help with a pharmacy claim or prior authorization, please contact the Medi-Cal Rx Customer Service Center at 1.800.977.2273 or you can send an email or chat here. Agents are available 24 hours a day, seven days a week, 365 days a year.
To submit a prior authorization or an appeal for a pharmacy claim to Medi-Cal Rx, please fax 1.800.869.4325.
If the pharmacy asks for a BIN, PCN, and Group information for billing your pharmacy claims, they will be processed under: BIN 022659, PCN 6334225, Group MEDICALRX.
You may also want to visit the Medi-Cal Rx Communication page for any upcoming bulletins and news.
- Medi-Cal Rx Website: Please bookmark this website and sign up for the Medi-Cal Rx Subscription Service (MCRxSS) to receive important information directly from DHCS.
- Medi-Cal Rx Provider Portal: Register to get access to beneficiary eligibility lookup, prior authorization, web claims submission, etc.
- Medi-Cal Rx Prior Authorization Requests and Appeals: Gold Coast Health Plan (GCHP) put together this information sheet about how to submit prior authorization requests and appeals to Medi-Cal Rx.
- Medi-Cal Rx Contract Drugs List (CDL): Please bookmark this website for the most up-to-date Contract Drugs List (CDL) from Medi-Cal Rx. It also includes other Covered Products Lists, such as Blood Pressure Monitoring Devices and Continuous Glucose Monitoring Systems.
Additional Medi-Cal Rx Resources
Medi-Cal Rx News
- Feb. 23, 2023: 30-Day Countdown – Phase III, Lift 1: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older
- Jan. 24, 2023: 30-Day Countdown – Reinstatement of Prior Authorization Requirements for 46 Drug Classes Including Medical Supplies
- Jan. 24, 2023: Medi-Cal Rx Phase II and Preparing for Phase III Transition Policy Retirement Frequently Asked Questions (FAQs)
- Jan. 19, 2023: Medical Supplies: How to Prepare for Retirement of the Transition Policy
- Dec. 20, 2022: Medi-Cal Rx Phase II FAQs
- Dec. 20, 2022: 30-Day Countdown – Reinstatement of Prior Authorization Requirements for 39 Drug Classes (effective Jan 20, 2023)
- Dec. 8, 2022: Medi-Cal Rx Reinstatement of Prior Authorizations and Retirement of the Transition Policy (Phases II, III, and IV)
Pharmacy Newsletters, DUR Educational Articles and FDA Communications
- DUR Educational Article, Jan. 27, 2023: Risks to Patients Exposed to Xylazine in Illicit Drugs
- DUR Educational Article, Jan. 27, 2023: Improving the Quality of Care: Treatment of Latent Tuberculosis Infection
- DUR Educational Article, Jan. 27, 2023: 2022 Immunization Update: Mpox, HepB, Influenza, COVID-19, Pneumococcal, Zoster
- DUR Educational Article, Jan. 20, 2023: Removal of DATA-Waiver (X-Waiver) Requirement
- Winter Newsletter, Dec. 2020
- Fall Newsletter, Sept. 2020
- DUR Bulletin, Aug. 31, 2020: 2020 Standards of Care for Treatment of Type 2 Diabetes
- Summer Newsletter, June 2020
- DUR Bulletin, May 29, 2020: Reproductive Health in Rheumatic and Musculoskeletal Diseases
- DUR Bulletin, April 30, 2020: Update of Risks Associated with Use of Fluoroquinolones
- DUR Bulletin, April 30, 2020: Withdrawal of All Ranitidine Products
- DUR Bulletin, March 31, 2020: Mental Health Side Effects from Montelukast
- Spring Newsletter, March 2020
- DUR Bulletin, Dec. 31, 2019: Risks Associated with Use of Gabapentin
- Winter Newsletter, Dec. 2019
- DUR Bulletin, Oct. 31, 2019: New Global Guidelines for the Treatment of Asthma
- DUR Bulletin, Sept. 27, 2019: Flu, HepA, HPV, Measles, CA School Requirements
- Fall Newsletter, Sept. 2019
- DUR Bulletin, Aug. 30, 2019: Concomitant Anticholinergic and Antipsychotic Use
- DUR Bulletin, June 28, 2019: Sleep Behavior Risks with Select Sleep Aids
- Summer Newsletter, June 2019
- DUR Bulletin, April 30, 2019: Risks with Sudden Discontinuation of Opioids
- DUR Bulletin, March 29, 2019: Updated Adverse Effects from Fluoroquinolones
- Spring Newsletter, March 2019
- DUR Bulletin, Feb. 28, 2019: Morphine Equivalent Daily Dose
- DUR Bulletin, Jan. 31, 2019:New Naloxone Regulations Effective on January 1, 2019
- DUR Bulletin, Sept. 28, 2018: Flu, Tdap, HepB, Zoster, MMR, Adult Vaccines
- DUR Bulletin, Sept. 28, 2018: Mandatory Use of CURES 2.0 Begins October 2, 2018
- Summer Newsletter, Aug. 2018
- DUR Bulletin, March 30, 2018: Pharmacist Furnishing Nicotine Replacement Products
- DUR Bulletin, Feb. 28, 2018: New Age Limit for Opioid Cough and Cold Medicines