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Provider Bulletin 05-28-2025 Important Provider Communication Reinstatement of PCS Form Requirement Effective June 1,2025 LA
Molina Healthcare·CA·Provider Bulletin
Effective date
Jun 1, 2025
We identified it
Jun 19, 2026
Summary
Molina Healthcare California is reinstating the requirement for Physician Certification Statement (PCS) forms for transportation services effective June 1, 2025. The PCS form requirement was temporarily waived due to fires but must now be completed for wheelchair vans, stretcher vans, and non-emergency ambulance services.
Action Required
By June 1, 2025: Providers must begin assisting Molina Medi-Cal members with completion and submission of PCS forms for transportation services including wheelchair accessible vans, stretcher/gurney vans, and non-emergency ambulance services. Submit forms online at molina.americanlogistics.com/pcs, by fax to (877) 282-8441, or email to molinafax@americanlogistics.com. Non-emergency ambulance services will not be scheduled without completed PCS forms after this date.