Part 2 - Pharmacy



Medi-Cal Program (00medi-cal) (Revision Date Aug 31, 2020) | (95KB)
Medi-Cal Provider Manual Contents (Revision Date May 29, 2020) | (81KB)
Manual Organization (0A man org) (Revision Date Aug 14, 2020) | (105KB)
How to Use This Manual (0B hw to use) (Revision Date Sep 16, 2020) | (371KB)
Getting Started: Where to Find the Answers (0C get start) (Revision Date Sep 16, 2020) | (196KB)
Appeal Form Completion (appeal form) (Revision Date Sep 16, 2020) | (631KB)
Blood and Blood Derivatives (blood) (Revision Date Sep 30, 2020) | (253KB)
California Children’s Services (CCS) Program (cal child) (Revision Date Oct 16, 2020) | (164KB)
CCS Program Billing Guidelines (cal child bil guide) (Revision Date Aug 18, 2020) | (108KB)
CIF Completion (cif co) (Revision Date Aug 31, 2020) | (701KB)
CIF Special Billing Instructions (cif sp) (Revision Date Oct 16, 2020) | (623KB)
CIF Submission and Timeliness Instructions (cif sub) (Revision Date Oct 16, 2020) | (177KB)
CMS-1500 Completion (cms comp) (Revision Date Aug 31, 2020) | (843KB)
CMS-1500 Special Billing Instructions (cms spec) (Revision Date Oct 16, 2020) | (212KB)
CMS-1500 Submission and Timeliness Instructions (cms sub) (Revision Date Aug 31, 2020) | (157KB)
CMS-1500 Tips for Billing (cms tips) (Revision Date Oct 16, 2020) | (165KB)
Compound Pharmacy Claim Form (30-4) Examples (compound ex) (Revision Date Aug 31, 2020) | (798KB)
Drugs: Contract Drugs List Introduction (drugs cdl intr) (Revision Date Aug 31, 2020) | (110KB)
Drugs: MAIC Rate Review (drugs maic rate) (Revision Date Aug 31, 2020) | (102KB)
Durable Medical Equipment (DME): An Overview (Revision Date Sep 16, 2020) | (126KB)
Durable Medical Equipment (DME): Bill for DME (dura bil) (Revision Date Oct 15, 2020) | (212KB)
Durable Medical Equipment (DME): Billing Examples (dura ex) (Revision Date Sep 16, 2020) | (4011KB)
End of Life Option Act Services (eloa) (Revision Date Aug 18, 2020) | (247KB)
Enteral Nutrition Products (enteral) (Revision Date Sep 16, 2020) | (232KB)
EPSDT (epsdt) (Revision Date Aug 31, 2020) | (126KB)
Forms: Legibility and Completion Standards (forms leg) (Revision Date Oct 16, 2020) | (129KB)
Forms Reorder Request: Guidelines (forms reo) (Revision Date Aug 14, 2020) | (110KB)
Forms Reorder Request: Pharmacy (forms reo ph) (Revision Date Sep 16, 2020) | (392KB)
Genetically Handicapped Persons Program (GHPP) (genetic) (Revision Date Sep 16, 2020) | (247KB)
Immunizations (immun) (Revision Date Aug 31, 2020) | (222KB)
Immunizations Code List (immun cd) (Revision Date Oct 16, 2020) | (127KB)
Incontinence Medical Supplies (incont) (Revision Date Sep 16, 2020) | (231KB)
Incontinence Medical Supplies Example: CMS-1500 (incont ex) (Revision Date Aug 14, 2020) | (1142KB)
Injections: An Overview (inject an over) (Revision Date Aug 31, 2020) | (135KB)
Injections: Code List (inject cd list) (Revision Date Oct 15, 2020) | (440KB)
Injections: Drugs A-D Policy (inject drug a-d) (Revision Date Oct 15, 2020) | (439KB)
Injections: Drugs E-H Policy (inject drug e-h) (Revision Date Oct 15, 2020) | (461KB)
Injections: Drugs I-M Policy (inject drug i-m) (Revision Date Oct 15, 2020) | (308KB)
Injections: Drugs N-R Policy (inject drug n-r) (Revision Date Sep 16, 2020) | (379KB)
Injections: Drugs S-Z Policy (inject drug s-z) (Revision Date Oct 15, 2020) | (249KB)
Injections: Hydration (inject hydra) (Revision Date Aug 31, 2020) | (118KB)
Medical Supplies (mc sup) (Revision Date Sep 30, 2020) | (237KB)
Medical Supplies: Billing Examples (mc sup ex) (Revision Date Aug 31, 2020) | (386KB)
Medicare-Covered Drugs (medicare drugs) (Revision Date Aug 31, 2020) | (142KB)
Medicare Non-Covered Services: HCPCS Codes (medi non hcp) (Revision Date Oct 15, 2020) | (136KB)
Orthotic and Prosthetic Appliances and Services (ortho) (Revision Date Oct 16, 2020) | (240KB)
Other Health Coverage (OHC) (oth hlth) (Revision Date Aug 31, 2020) | (130KB)
Pharmacy Claim Form (30-1) Completion (pcf30-1 comp) (Revision Date Oct 16, 2020) | (333KB)
Pharmacy Claim Form (30-1) Examples (pcf30-1 ex) (Revision Date Aug 31, 2020) | (1058KB)
Pharmacy Claim Form (30-1) Tips (pcf30-1 tips) (Revision Date Aug 31, 2020) | (140KB)
Pharmacist Services (pharm serv) (Revision Date Aug 31, 2020) | (196KB)
Physician-Administered Drugs (physician) (Revision Date Sep 30, 2020) | (141KB)
Presumptive Eligibility for Pregnant Women (presum) (Revision Date Aug 31, 2020) | (157KB)
Reimbursement (reimbursement) (Revision Date Sep 16, 2020) | (208KB)
Remittance Advice Details (RAD) (remit adv) (Revision Date Aug 31, 2020) | (129KB)
Share of Cost (SOC): 30-1 for Pharmacy (share ph) (Revision Date Aug 31, 2020) | (867KB)
Sign Language Interpretation (sign) (Revision Date Aug 31, 2020) | (136KB)
Subacute Care Programs: Adult (subacut adu) (Revision Date Aug 31, 2020) | (134KB)
Subacute Care Programs: Pediatric (subacut ped) (Revision Date Aug 31, 2020) | (136KB)
TAR Completion (tar comp) (Revision Date Aug 31, 2020) | (384KB)
TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer) (Revision Date Sep 28, 2020) | (549KB)
TAR Field Office Addresses (tar field) (Revision Date Sep 16, 2020) | (380KB)
TAR Submission: Drug TARs (tar sub drug) (Revision Date Sep 16, 2020) | (173KB)
TAR Submission: Transmittal Form (tar submis) (Revision Date Aug 31, 2020) | (220KB)
TAR: Submitting Appeals (tar submit) (Revision Date Sep 28, 2020) | (114KB)
Taxable and Non-Taxable Items (tax) (Revision Date Sep 16, 2020) | (324KB)


Note:
If you cannot view the MS Word or PDF (Portable Document Format) documents correctly, please visit the Web Tool Box to link to a download site for the appropriate reader.