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Medi-Cal News Articles

Title

Category

Publish Date

Beneficiary Eligibility Verification Reminder

Reminder to providers to verify beneficiary eligibility and the Medi-Cal billing policy before providing services.

DHCS Notice

08/11/2022

Monkeypox Services and Reimbursement for FQHC, RHC, IHS-MOA and Tribal FQHC Providers

The Department of Health Care Services (DHCS) continues to closely monitor the Monkeypox situation and provide updates and guidance to Medi-Cal providers.

DHCS Notice

08/08/2022

Coming Soon: Monkeypox Vaccines as Medi-Cal Benefits

Two Monkeypox Vaccines will soon be available as Medi-Cal Benefits.

DHCS Notice

08/05/2022

New Provider Financial Data Request Form Available

To aid providers with requesting financial data from the Financial Cash Control Unit (FCCU), a specific request form is now available.

Forms

08/03/2022

Coming Soon: Novavax COVID-19 Vaccine Authorization

The FDA has amended the EUAs for the addition of the Novavax COVID-19 vaccine for individuals 18 years of age and older.

COVID-19

08/03/2022

Reminder: Introduction of Therapeutic Substance into Mouth and Pharynx Not Restricted to Females

ICD-10-CM code 3E0DXGC is not restricted to female patients. An EPC will be implemented to reprocess erroneously denied claims.

Claims

08/03/2022

September Virtual Claims Assistance Room Event

Providers may receive free one-on-one billing assistance at the Virtual Claims Assistance Room (CAR) event scheduled for the month of September.

Billing

08/01/2022

Temporary Problem for Real-Time Eligibility Transactions

The Medi-Cal Program has been affected by a temporary problem that has affected all providers using CalPOS leased line connection for Real-Time eligibility transactions.

DHCS Notice

07/29/2022

New Approval Messages for COVID-19 Uninsured Group User Guide

COVID-19 Uninsured Group (UIG) coverage will be updated with new approval messages for qualifying individuals.

COVID-19

07/29/2022

Coming Soon: Laboratory Test CPT Code for the Orthopoxvirus

New CPT code 87593 created to streamline the reporting of monkeypox testing. Notification for claims submission to follow.

Billing

07/28/2022

Update for Paper RADs and No Pay Documents

The discontinuance of paper RAD, Electronic Fund Transfer and No Pay documents has been extended. No future discontinuance date has been announced.

Claims

07/27/2022

Aid Code A1 Benefits Update for HACCP

New Medi-Cal benefits for aid code A1-Hearing Aid Coverage for Children Program (HACCP): L8691, L8694, and L8692.

Programs

07/25/2022

Modifications to DETEC for EWC Program

The EWC program will implement new modifications to data entry fields in the EWC data entry applications known as DETEC.

Every Woman Counts

07/25/2022

FDA Approves COVID-19 Vaccine for Children 6 Months and Up

FDA amends EUA for COVID-19 vaccines, approving vaccinations for children ages six months to 17 years of age.

COVID-19

07/25/2022

Coming Soon: Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments

Coming Soon: retention payments for California health care workers in qualifying facilities.

DHCS Notice

07/22/2022

Update: FQHC, RHC and Tribal FQHC Providers Claim Submission for COVID-19 Vaccine Administration

FQHC, RHC and Tribal FQHC providers may resubmit claims billed for an amount less than intended for COVID-19 vaccine administration after submission timelines using an electronic method.

COVID-19

07/19/2022

Paper RADs And No Pay Documents Will No Longer Be Mailed Due To Supply Chain Issues

Effective 7/18/2022, RAD, EFT and No Pay documents will only be available electronically and not be mailed due to supply chain issues.

Billing

07/14/2022

PHE Telehealth Policy Clarification for Medication Abortion: HCPCS Code S0199

PHE Telehealth Policy Clarification for Medication Abortion.

COVID-19

07/13/2022

New PACE Managed Care in Los Angeles County

Effective for dates of service on or after July 1, 2022, ConcertoHealth Program of All-Inclusive Care for the Elderly (PACE) opens a new Managed Care Plan (MCP) in Los Angeles County.

Billing

07/07/2022

Public Provider Ground Emergency Medical Transportation Intergovernmental Transfer Program Training

DHCS is holding an informational training on the PP-GEMT IGT Program.

DHCS Notice

07/05/2022

August 2022 Medi-Cal Provider Training Webinars

O&E announces the August 2022 Medi-Cal provider training webinars.

Outreach and Education

07/01/2022

HPV Vaccine Added as Family PACT Benefit

HPV vaccine is added as a clinic benefit for the Family PACT program.

Billing

07/01/2022

2022 HCPCS Quarter 3 Update

HCPCS

06/30/2022

Walk-Up Claims Discontinued

Medi-Cal will no longer accept walk-up claims. Providers will need to submit claims through mail or electronic submissions.

Billing

06/30/2022

SFY 2022-2023 DRG Grouper Settings documents will be updated to reflect 3M Grouper software update.

Billing

06/30/2022

Medi-Cal Coverage of Community Health Worker (CHW) Services is Effective July 1, 2022

Effective July 1, 2022, Medi-Cal covers Community Health Workers (CHW) services, including violence prevention services and asthma preventive services. This NewsFlash contains information describing the CHW benefit, including billing codes and rates.

Billing

06/29/2022

Public Provider Ground Emergency Medical Transportation Intergovernmental Transfer Program

DHCS announces a new Public Provider Ground Emergency Medical Transport Intergovernmental Transfer Program program to provide increased reimbursements to emergency medical transports.

DHCS Notice

06/29/2022

Coming Soon: COVID-19 Vaccine for Children 6 Months and Up

Coming Soon: FDA amended EUA to allow COVID-19 vaccines for individuals 6 months and older.

DHCS Notice

06/28/2022

New Requirements and Procedures for Non-Medical Transportation Enrollment

New requirements and procedures are established for non-medical transportation providers’ enrollment, in effect of Welfare and Institutions Code (W&I Code), Section 14132(ad)(1).

Bulletin Announcements

06/27/2022

Pfizer COVID-19 Vaccine Booster Dose Approved for Individuals 5 to 11 Years Old

Pfizer booster approved for individuals 5 to 11 years old.

COVID-19

06/23/2022

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Part 1 - Medi-Cal Program & Eligibility Bulletin

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Acupuncture (ACU)