PEBTF specialty drug carve-out through CVS Specialty

PEBTF members need to use the CVS Specialty care pharmacy for most specialty medications, including injections and infusions that are administered by a provider on an outpatient basis. 

PEBTF and CVS maintain a specialty pharmacy drug list. Drugs on that list must be filled through the pharmacy benefit plan and billed under the pharmacy benefit, not the medical plan. Exceptions are noted on the list, particularly injectable products used for oncology indications which are permitted to be billed under the medical benefit. The list is subject to change.

PEBTF members should be directed to CVS Specialty at 800-237-2767 to enroll. The CVS Specialty Pharmacy Drug List can be found at pebtf.org under Publications and Forms.