Medi-Cal RX Transition 2021
Medi-Cal Rx Support Services
The following document will provide the processing information for Medi-Cal Rx (i.e. BIN & PCN) and additional payer information.
Medi-Cal Rx Support Services and Key Payer Sheet Details
Pharmacies requesting additional operational claims support please contact-
Medi-Cal Rx Customer Service Center at: (800) 977-2273
Physician-Administered-Drugs
New Pharmacist Services
New Pharmacist Services as a CenCal Health Benefit
CenCal Health will be adding the ability for Pharmacies to bill for specific clinical services rendered by a pharmacist. All added services follow California Assembly Bill 1114, which outlines the specified pharmacist services that are a reimbursable Medi-Cal benefit when rendered to a Medi-Cal Managed care member in the outpatient pharmacy setting. CenCal Health would like to solicit initial interest for provider participation during August and September before implementation of the program.
Please see the initial details for the new program below:
- Eligible Members
- A patient who has active CenCal Health enrollment for the date of service
- Eligible Pharmacist Services
- Eligible Pharmacist Services
- Furnishing travel medications
- Furnishing self-administered hormonal contraception
- Initiating and administering immunizations
- Providing tobacco cessation counseling and furnishing nicotine replacement therapy
- Accepted Billing Code
- Evaluation and Management (E&M) billing codes:
- 99201-New patient
- 99212-Established patient
- Administration billing code:
- 90471-Vaccine administration
For further information on the above program, or if you would like to inquire about becoming contracted with CenCal Health to provide the above service, please contact the CenCal Health Pharmacy Department at (805) 562-1080.