Submitting Claims for CPPCC Operation Hours

Last Updated: February 2, 2026

When billing for daily Community Pharmacy Primary Care Clinic (CPPCC) hours, you would submit the claim in the same way as a drug claim using a dummy PHN.

CPPCC Operation Hours PINs

Table 1. CPPCC Operation Hours PINs.

PIN Trade Name Drug Cost
92099599 NS PPCC: CLINIC OPERATIONAL HOUR $80
92099600 NS PPCC: CLINIC NON-OPERATIONAL HOUR $80
92099650 NS PPCC: UNFUNDED NON-OPERATION HOUR N/A*

*This PIN is used for tracking and evaluation purposes only and is not reimbursed.

Setting Up the Patient Folder

You will need to create a Patient Folder for the purposes of billing clinic hours. This Patient Folder does not need to be synchronized with the DIS and should therefore be assigned an Animal patient status. You only need to create this Patient Folder once and it will be used for all future billings of clinic hours.

The dummy PHN is shadowed; cannot be retrieved from the Client Registry.

To create the Patient Folder:

  1. Select the Patient navigator button .

  2. The Patient Search window opens. In the Last Name field, enter "ZZZZZ".

  3. Select Search.

  4. Select New.

  5. Enter the following information in the Patient Folder Main tab.

    • Last Name - ZZZZZ

    • First Name - CPPCC OPERATION HRS

    • Birth Date - April 1, 1969

    • Gender - Male

    • Status - Animal

    • PHN - 0016675191

    • Address - pharmacy's address

  6. Select the Third Party tab.

  7. Select Add.

  8. The Third Party Plan Search window opens. Search for and select MSI Pharmacare - General (Bill Code = MS).

  9. In the Client ID field for the MS plan, enter "0016675191".

  10. Select Save.

Submitting the Claim

A single claim should be submitted for daily hours. However, since the dummy PHN is used by every CPPCC for billing clinic hours, you will need to enter the "MG" intervention code to override duplicate claims detected by Pharmacare.

To submit the claim:

  1. From the Workbench or Patient Profile, select New.

  2. Enter the following information in the Intake window:

    • Patient - ZZZZZ, CPPCC OPERATION HRS (if not already selected)

    • Prescriber - any pharmacist working at your pharmacy

    • Drug - applicable PIN from Table 1

    • QA - hours to one decimal place

    • Qty - hours to one decimal place

    • SIG

    • DS - 1

  3. Select Process.

  4. In Rx Detail, confirm the Cost matches Table 1 and the Markup and Fee are $0.

  5. Select the Third Party tab.

  6. For the MS portion of the claim, select Add.

  7. Select the "MG - Override - Various Reasons" intervention code.

  8. Select Fill.