PharmaCare Policy Manual
Last updated: September 19, 2023
For the mandate and scope of the Prosthetic and Orthotic Program, see the P&O Policy Manual.
- Section 2.1 PharmaCare Enrolment
- Section 2.2 Non-Pharmaceutical Supplier Participation Agreement (Removed)1
- Section 2.3 What is PharmaNet?
- Section 2.4 Connecting to PharmaNet
- Section 2.5 Changes to PharmaNet Connections
- Section 2.6 Dealing with PharmaNet Network Outages
- Section 2.7 Fan-Out Messages
1Non-pharmaceutical suppliers now enroll as device providers under the Provider Regulation.
For response and intervention codes, see Appendix A (PDF, 222KB) and Appendix B (PDF, 215KB).
- Section 3.1 Which Transactions to Submit on PharmaNet
- Section 3.2 Patients: Identification
- Section 3.3 Patients: Personal Health Numbers
- Section 3.4 Patients: Other Payers
- Section 3.5 Patients: Restricted Claimant Program
- Section 3.6 Patients: With Out-of-Province and Out-of-Country Prescriptions
- Section 3.7 Medical Practitioners: Prescriber IDs & Practitioner Reference IDs
- Section 3.8 (Removed)
- Section 3.9 Medical Practitioners: Authorized Prescribing
- Section 3.10 Medical Practitioners: Practicing Status and Practitioner Restrictions
- Section 3.11 Medical Practitioners: BC Prescription Review Program
- Section 3.12 Drug and Product Identification Numbers
- Section 3.13 Correct Quantities
- Section 3.14 Drug Use Evaluation (DUE)
- Section 3.15 Drug Monograph Information
- Section 3.16 Claim Reversals
- Section 3.17 Prescription Discontinuations
- Section 3.18 Claims for Drug Cost Exceeding $9,999.99
- Section 3.19 Recording Adverse Drug Reaction and Allergy Information in PharmaNet
- Section 5.1 Maximum Days Supply Policy
- Section 5.2 Refilling Prescriptions Too Soon Policy
- Section 5.3 Refilling Prescriptions on the Same Day Policy
- Section 5.4 Travel Supply Policy
- Section 5.5 Correct Quantities Policy
- Section 5.6 Maximum Pricing Policy
- Section 5.7 Actual Acquisition Cost Policy
- Section 5.8 High-Cost Drugs Policy
- Section 5.9 Retail Pricing Policy
- Section 5.10 Full Payment Policy
- Section 5.11 Low Cost Alternative Program
- Section 5.12 Reference Drug Program (RDP)
- Section 5.13 Compounded Prescriptions
- Section 5.14 Insulin
- Section 5.15 Needles and Syringes
- Section 5.16 Blood Glucose Testing
- Section 5.17 Insulin Pumps
- Section 5.18 Insulin Pump Supplies
- Section 5.19 Reimbursement for Non-Returnable High-cost Injectable Drugs
- Section 5.20 Smoking Cessation Program Policy
- Section 5.21 Ostomy Supplies
- Section 5.22 Prosthetics and Orthotics
- Section 5.23 Pricing Exceptions Where Multiple Dosage Forms or Strengths Are Available
- Section 7.1 Plans Overview
- Section 7.2 Fair PharmaCare
- Section 7.3 Long-term Care (Plan B)
- Section 7.4 Recipients of Income Assistance (Plan C)
- Section 7.5 Cystic Fibrosis (Plan D)
- Section 7.6 Children in the At Home Program (Plan F)
- Section 7.7 Psychiatric Medications (Plan G)
- Section 7.8 Palliative Care (Plan P)
- Section 7.9 Medication Management (Plan M)
- Section 7.10 Smoking Cessation Program (Plan S)
- Section 7.11 British Columbia Centre for Excellence in HIV/AIDs (Plan X)
- Section 7.12 First Nations Health Benefits (Plan W)
- Section 7.13 Assurance (Plan Z)
- Section 8.1 About Pharmacy Fees and Subsidies
- Section 8.2 Dispensing Fees
- Section 8.3 Frequency of Dispensing Policy: Fee Limits
- Section 8.4 Clinical Services Fees
- Section 8.5 Special Services Fees
- Section 8.6 Trial Prescription Program
- Section 8.7 Capitation Fees for Plan B (Long-term Care)
- Section 8.8 Methadone Maintenance Payment Program
- Section 8.9 Medication Review Services
- Section 8.10 Pharmacist Administration of Drugs and Vaccines
- Section 8.11 Rural Incentive Program
- Section 8.12 Payments to Providers
- Section 8.13 Payments for Patient Support Fees
- Section 8.14 Minor Ailments and Contraception Service (MACS)
- Appendix A Response Codes — PharmaNet adjudication response codes
- Appendix B Intervention Codes — PharmaNet intervention and exception codes
- Appendix C Reference Codes — Practitioner ID reference codes
PharmaCare Policy Manual Version 1.0 March 2012, with amendments.