55 Pa. Code § 1121.51
Payment is made for covered pharmaceutical services provided by participating pharmacies, subject to the conditions and limitations in this section and § § 1121.52—1121.56a 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/developmental services programs operated under the Mental Health and Intellectual Disability 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.
The provisions of this § 1121.51 amended under sections 201(2) and 403.1(a)(4) of the Human Services Code (62 P.S. § § 201(2) and 403.1(a)(4)).
The provisions of this § 1121.51 amended January 2, 2026, effective January 3, 2026, 56 Pa.B. 16. Immediately preceding text appears at serial page (422711).
This section cited in 55 Pa. Code § 1121.54 (relating to noncompensable services and items).