Pharmacy reimbursement fee-for-service
The following resources are available to assist you with submitting pharmacy-related claims.
- Pharmacy reimbursement rules and Washington Administrative Codes (WAC).
- Current fee-for-services state maximum allowable cost (SMAC) list.
- Current fee-for-service list of drugs with five or more manufacturers excluded from AWP-50%.
To request a change in reimbursement, please download the Pharmacy Information Authorization form (13-835A). Fax the request to: (866) 668-1214.