Pharmacy Services for Providers

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.

Important links

• 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 Bulletins & News
• Medi-Cal Rx Provider Portal
• Medi-Cal Rx Forms & Information

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)

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