A system and apparatus for medication container sorting are disclosed. A container sorting apparatus includes a belt support extending from a loading section to a downstream end and defining a belt track and a cam track. A transport mechanism moves containers onto a cleated belt that advances along the belt track. The cleated belt includes multiple rows configured to receive and retain containers during transport from the loading section to the downstream end. A cam belt disposed within the cam track moves in coordination with the cleated belt and includes rows aligned with the rows of the cleated belt. Cam-driven probes associated with corresponding rows are selectively actuatable to extend into and retract from the cleated belt rows to facilitate controlled handling or sorting of containers at a predetermined position along the belt support.