Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1121 - PHARMACEUTICAL SERVICES
PAYMENT FOR PHARMACEUTICAL SERVICES
Section 1121.51 - General payment policy

Universal Citation: 55 PA Code ยง 1121.51
Current through Register Vol. 54, No. 44, November 2, 2024

Payment is made for covered pharmaceutical services provided by participating pharmacies subject to the conditions and limitations in this section and §§ 1121.52-1121.56 and Chapter 1101 (relating to general provisions). Payment will not be made for a compensable pharmaceutical service if payment is available from another public agency or another insurance or health program. This does not apply to MA recipients whose drugs have been prescribed through the County Mental Health/Mental Retardation Programs operated under the Mental Health and Mental Retardation Act of 1966 (50 P. S. §§ 4101-4704). In this instance only, providers may bill the MA Program for services as specified in this chapter.

This section cited in 55 Pa. Code § 1121.54 (relating to noncompensable services and items).

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