Pharmacy and drug authorizations

Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

pharmacy prior auth

Pharmacy Services — physician-administered drug PA

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Phone800-867-6564Fax

833-953-3436

Published hours

Not published in this record

Product, plan and location

medicaid
California

Mailing address

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Menu guidance in the source record

Option 2.

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CalViva Health Medi-Cal (Fresno, Kings, Madera counties) is administered by Health Net; this contact comes from the CalViva prior authorization list effective October 1, 2026. PA for drugs administered in a physician's office (including self-injectables given in office). Outpatient pharmacy drugs are Medi-Cal Rx.

View source ↗ · Source checked 2026-10-25

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Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

Have ready in your secure workspace

PBM name and the pharmacy identifiers on the card
Drug, formulation and prescription information
Prescriber details and previous review reference

Questions to resolve

Is this processed under the medical or pharmacy benefit?
What is the correct review and submission channel?
Is there a separate specialty pharmacy or appeal team?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

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