Skip to main content
  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 08/20/14

Provider Bulletin P-200 14-02

To:​ ​Enrolled Pharmacies
​Date: ​August 20, 2014
Re:​ Chapter P-200, Handbook for Providers of Pharmacy Services Recipient Restriction Program​

The purpose of this notice is to inform providers of a department change regarding the billing process for participants that have been restricted to a specific clinic and have been prescribed medication. Effective immediately, providers should follow the process outlined below when dispensing and billing for a medication when the participant is restricted to a clinic. Please refer to the Pharmacy Chapter P-200 notice, dated February 18, 2014 for information regarding claims submitted for a participant restricted to a physician.

In instances where the client is restricted to a clinic, the prescribing physician should be identified in the Prescriber ID field (411-DB) and the clinic (clinic to which the participant is restricted) should be identified, by clinic NPI, on the claim as the primary care physician in the Primary Care Provider ID field (421-DL).

Providers who have questions about a participant’s RRP status may call the Department’s toll-free RRP hotline at 1-800-325-8823.

The Handbook for Providers of Pharmacy Services has been updated and is available on the department’s Web site. Any questions regarding this bulletin should be directed to your facility’s medical assistance consultant in the Bureau of Professional and Ancillary Services at

1-877-782-5565, Option 7.

Instructions for updating the Handbook for Providers of Pharmacy Services:

P-210 Recipient Restriction Program - Remove page HFS P-210 (1-2) and insert new page HFS P-210(1-2).

P-210.1 Replacement Pages (pdf)