Since January 1, 2022, Medi-Cal members’ pharmacy services have been primarily managed by the California Department of Health Care Services (DHCS) through their Medi-Cal Rx program. However, there is one exception: HPSM still covers physician administered drugs (PADs), which are medicines that providers administer to patients in an office or clinic setting. You may need pre-approval (prior authorization) from HPSM for coverage of PADs based on medical necessity.
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- Alternative Access Standards 2025
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CareAdvantage D-SNP 2027 Member Handbook
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Exceptional Employee Benefits
Exceptional Employee Benefits
Medi-Cal: HPSM Still Covers Physician Administered Drugs
31 May, 02:19 PM
Medi-Cal: HPSM Still Covers Physician Administered Drugs
May 31, 2023, 21:19 PM
Members
HPSM Grievance and Appeals
For help filing a complaint about services you received or an appeal about a coverage decision.
Contact information:
Phone: 650-616-2850
Toll free: 1-888-576-7227
Fax: 650-829-2002
Hours: Monday–Friday 8:00 a.m. to 5:00 p.m.
HPSM Dental
For help with HPSM Dental services, claims and referrals.
Contact information:
Phone for dental services: 650-616-2106
Phone for dental claims and referrals: 650-616-1522
Hours: Monday to Friday 8:00 a.m. 5:00 p.m.