Pharmacy Services

The Pharmacy Services program of the Department of Human Services (DHS, "the Department") oversees the outpatient prescription drug benefit for all Pennsylvania Medical Assistance (MA)-eligible beneficiaries and administers the pharmacy benefit for beneficiaries receiving services in the Fee-for-Service (FFS) program (i.e., ACCESS). The FFS pharmacy benefit encompasses all covered outpatient drugs as defined by the Social Security Act of 1927.

The pages linked below contain helpful information for providers and pharmacies rendering services in the FFS delivery system. Information regarding services administered in the Pennsylvania MA managed care delivery system is available from the specific managed care organizations. 

UPDATED (10/3/2022) - Pharmacy Reference Guide: Billing for the Administration of COVID-19 Vaccines to FFS Beneficiaries

Statewide Preferred Drug List (PDL)

• Statewide PDL General Information 
  
• Statewide PDL Classes and Drugs (opens in a new window)
• DHS Pharmacy and Therapeutics (P&T) Committee Information
  

Bureau of Fee-for-Service Programs - Pharmacy Services

• Covered Drugs Search Tool
• DHS Drug Utilization Review (DUR) Board Information
• Prior Authorization General Requirements and Procedures
• Prior Authorization Clinical Guidelines
• Prior Authorization Fax Forms
• Quantity Limits/Daily Dose Limits
• Specialty Pharmacy Drug Program
• State MAC List

PROMISe

• PROMISe Claims Processing and Management System Information
• PROMISe Eligibility Verification System (EVS)
• Error Status Codes and Descriptions
• FFS Common Billing Errors for Drugs 

General

• DHS General Information
• DHS Bulletin Search
  
• DHS Medical Assistance Advisory Committee (MAAC) Information
• DHS Centers of Excellence for Opioid Use Disorder 
• Information for 340B Covered Entities
• Vaccines for Children Program (Pennsylvania Department of Health)  

Contact Us

Pharmacy Services Help Desk
Monday - Friday 8:00 AM - 4:30 PM
Phone: 1-800-537-8862