PCS - Canadian Pharmacy Claim Standard, Trial Use
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Table of Contents
Business Overview
PCS Overview
Current State
New Features & Functions High Level View
Quebec Legislative Requirements
Alignment with Canadian Standards
PCS Support
Planned Implementation Work Items - 2026
Getting Started - Business & Technical Audiences
Phase 1 - MVP Scope
MVP Scope Overview
Bundle & Message Header - New Fields
01-Claim Request - Medication - New Fields
02-Claim Request - Professional Services-New Message
11-Reversal Request - New Fields
30-31- Request For Daily Totals & Adjudication Details
51-52- Claim Response - Medication & Proff services - New Fields
61 - Reversal Response - New Fields
80-Daily Totals Response - New Fields
81-Adjudication Details Response - New Fields
FHIR Message Structure
Claim Request Medication Message Structure
Claim Response - Message Structure
Claim Request - Professional Services Message Structure
Claim Response - Professional Services Message Structure
Claim Reversal Message Structure
Claim Reversal Response Message Structure
Daily Totals and Details Request Message Structure
Totals and Details Responses Message Structure
Claim Response - Errors
CPHA3 - FHIR Field Level Mappings
Claim Request & Reversal Mappings
Response Messages Mappings
Get Totals and Details Request Mappings
Daily Totals Response Mappings
Adjudication Details Response Mappings
Complex Mapping Rules FHIR-CPHA
Event Codes /CPHA Code Mapping
Technical Topics and Profiles
Technical Overview, FHIR RESTful API
Operations Overview
API Definition & Example
Error Handling
Guaranteed Delivery using Key Identifiers
Key Identifiers
FHIR Tooling
Digital Signature - Prior Claim Results
Capability Statements, Capability Tracking
PCS Release Management
Change Log - Internal Use Only
Link to FHIR Home Page
FHIR Profiles
Terminology - Field Values
Overview and Maintenance
Complete Terminology List
Alert Codes
Adjudication Category
Assigning Authority Pharmacist
Canadian Jurisdiction/Province Codes
Coverage Type
Claim Response Outcome Code
Claim Response Item Adjudication Codes
Dispense Type - CPHA New/Refill Code
Dispense.status FINAL
Diagnosis System - FINAL
Dispense Claim Item Detail Codes
Dispensed Quantity Unit Codes
Error Messages Future
DUR Managed Codes
Event Codes
Gender
Healthcare Role
Intervention & Exception Codes
Intervention Result "U" codes Table 4
Intervention "C" codes, Refusal to Fill Table 2
Intervention Codes - Code Systems
Identifier Type
Jurisdictional Healthcare Identifier Type
Level of Service Codes, SSC TWG Table 5 DISCUSS/DEPRECATE
Message Version
Medication Code
Medication Dispense Type
Message Protocol/Assigning Authority TWG review
Note Language
New Refill Code - Final
National Pharmacy ID Code
Not Performed Reason HL7/Intervention C
Note Type
Orderable Drug Form Quantity Unit
Payee Type Code - NEW FHIR
Program Type
Prescriber ID Reference
Provider Software ID - Issued later
Professional Service Codes
Product Selection
Relationship Codes
Reversal Response Codes
Reversal Response Status
Response Codes
Response Code - Code System Identifier
Response Status - DRAFT
Software Vendors - Certified FHIR
Special Service Codes Table 3
SupportingInformationCategoryCodes
Therapeutic Substitution Code
Unlisted Compound
Message Samples
01-Claim Request - Dispense
02-Professional Service Claim
51-Claim Response - Dispense
52-Professional Service Response
30-Daily Totals Request
31-Adjudication Details Request
81-Adjudication Details Response
80-Daily Totals Response
11-Reversal Request
61-Reversal Response Accepted
Link to FHIR Home Page
FHIR Home Page
