Drug Utilization Review (DUR) Update |
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The Drug Utilization Review (DUR) website is temporarily inaccessible. Meeting notices will be posted on this page until the DUR website is operational again. |
The purpose of the Iowa Medicaid Pharmacy webpage is to guide providers to available Iowa Medicaid Pharmacy resources.
Pharmaceutical and Therapeutics (P&T) Committee
To learn more about the P&T Committee, visit the Iowa Medicaid Preferred Drug List (PDL) website.
Drug Utilization Review (DUR) Committee
House File 653 established a requirement for the Pharmaceutical and Therapeutics (P&T) Committee and the Drug Utilization Review (DUR) Commission to request and consider information from individuals who possess scientific or medical training with respect to drugs and biological products for rare diseases and drugs and biological products that are genetically targeted when making recommendations or determinations regarding beneficiary access.
Pharmacy Resources
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Pharmacy Reimbursement Portal
AAC Rate Review Request, Pharmacy Cost of Dispensing Survey
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Iowa Medicaid PDL
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Provider Policy Manuals
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Pharmacy Dispensing Fee
This is also linked on the Iowa Medicaid Fee Schedule homepage.
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Informational Letters
ILs
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Fee Schedules
Select ‘Open Fee Schedules’ from the homepage to view the Pharmacy Fee Schedules.
Type Code 82 – Pharmacist
Type Code 08
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Provider Enrollment Toolkit
Instructions for Pharmacy Providers
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Provider Enrollment Homepage
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CMS 1500 Claim Form Instructions
Fee-for-Service Medical Billing
MCO Provider Resources
To view provider resources under one of the managed care organizations (MCOs), please visit the below links.
- Pharmacy Homepage
- Prior Authorization Lookup Tool
- Provider Enrollment
- Contact Information:
- Pharmacy Help Desk (POS): 1-833-236-5925
- Provider Services (Medical): 1-833-731-2143
- Pharmacy Homepage
- Prior Authorization Lookup Tool
- Provider Enrollment
- Contact Information:
- Pharmacy Help Desk (POS): 1-833-750-4405
- Provider Services (Medical): 1-833-404-1061
- Pharmacy Homepage
- Prior Authorization Lookup Tool
- Provider Enrollment
- Contact Information:
- Pharmacy Help Desk (POS): 1-800-349-0679
- Provider Services (Medical): 1-844-236-1464
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For telephone accessibility assistance if you are deaf, hard-of-hearing, deaf-blind, or have difficulty speaking.
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