Note that the contact information differs depending on the type of California Medicaid prior authorization form request.
- Self-administered non-specialty medications (US Script)
- Fax number:1 (866) 399-0929
- Phone number: 1 (877) 277-0413
- Self-administered specialty medications (AcariaHealth)
- Fax number: 1 (855) 217-0926
- Phone number: 1 (855) 535-1815
- Physician-administered specialty medications (California Health & Wellness Pharmacy Department)
- Fax number: 1 (877) 259-6961
- Phone number: 1 (877) 658-0305