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Pharmacist Services: New Family PACT Benefit

June 6, 2019

Effective for dates of service on or after April 1, 2019, pharmacist services are reimbursable as a Family Planning, Access, Care and Treatment (Family PACT) Program benefit.

Assembly Bill 1114, Chapter 602, Statutes of 2016, added Welfare and Institutions Code, Section 14132.968, which established pharmacist services as a benefit. These services include furnishing self-administered contraception, as authorized in Business and Professions Code, Section 4052.3.

CPT codes 99201 (evaluation and management of a new patient) and 99212 (evaluation and management of an established patient) are reimbursable with any of the following ICD-10-CM diagnosis codes: Z30.011, Z30.012, Z30.015, Z30.016, Z30.09, Z30.41, Z30.44 and Z30.45.

An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. No action is required of providers.

Updated manual pages will be released in a future Family PACT Update.