Medi-Cal Update

AIDS Waiver Program | July 2017 | Bulletin 514

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1. Get the Latest Medi-Cal News: Subscribe to MCSS Today


The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails for urgent announcements and other updates shortly, after posting on the Medi-Cal website.

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2. Authorized Drug Manufacturer Labeler Codes Update

The Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes section has been updated as follows.

Additions, effective July 1, 2017
NDC Labeler Code Contracting Company's Name

This information is reflected in the following provider manual(s):

Provider Manual(s) Page(s) Updated
Adult Day Health Care Centers
AIDS Waiver Program
Chronic Dialysis Clinics
Clinics and Hospitals
Expanded Access to Primary Care Program
General Medicine
Heroin Detoxification
Home Health Agencies/Home and Community-Based Services
Hospice Care Program
Multipurpose Senior Services Program
Rehabilitation Clinics
drugs cdl p5 (18, 19)
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3. Three Reimbursement Rates Changed in AIDS Waiver Program

Effective retroactively for dates of service on or after January 1, 2017, the maximum allowable reimbursement for each client in the AIDS Waiver Program is $25,727 per calendar year.

Also effective retroactively for dates of service on or after January 1, 2017, HCPCS codes T2028 (specialized supply, not otherwise specified, waiver) and T2029 (specialized medical equipment, not otherwise specified, waiver) are reimbursed “By Report” and are not subject to the $1,000 calendar year cap rate per client. 

This information is reflected in the following provider manual(s):

Provider Manual(s) Page(s) Updated
AIDS Waiver Program aids (5, 11, 16); aids bil cd (1)
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4. National Correct Coding Initiative Quarterly Update for July 2017

The Centers for Medicare & Medicaid Services has released the quarterly National Correct Coding Initiative payment policy updates. These mandatory national edits have been incorporated into the Medi-Cal claims processing system and are valid for dates of service on or after July 1, 2017.

For additional information, refer to The National Correct Coding Initiative in Medicaid page of the Medicaid website.

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5. Reminder: Avoid Printing Data in Margins of Paper Claim Forms

In order to ensure timely and accurate claims processing, providers are reminded to avoid printing data in the margin, header or footer portion of paper claim forms. Overlapping data may be misread. For example, processing has been delayed for certain claims with address information typed in the header portion of the CMS-1500 claim form.

The Billing Tips: Paper Claims page of the Medi-Cal website has been updated to reflect the above and to align with a previously published NewsFlash article titled “Reminder: Paper Claim Submission Guidelines.” For more general reminders about paper claim submission, please visit the page or call the Telephone Service Center (TSC) at 1-800-541-5555.

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6. August 2017 Medi-Cal Provider Seminar

The August Medi-Cal provider seminar is scheduled for August 15 – 16, 2017, at the Sacramento Marriott in Sacramento, California. Providers can access a class schedule for the seminar by visiting the Provider Training page of the Medi-Cal Learning Portal (MLP) and clicking the seminar date(s) they would like to attend. Providers may RSVP by logging in to the MLP.

Throughout the year, Department of Health Care Services (DHCS) and Conduent, the Fiscal Intermediary for Medi-Cal, conduct Medi-Cal training seminars. These seminars, which target both novice and experienced providers and billing staff, cover the following topics:

Providers must register by August 1, 2017, to receive a hard copy of the Medi-Cal provider training workbooks on the date(s) of training. After August 1, 2017, the workbooks will be available only by download on the Medi-Cal Provider Training Workbooks Web page on the Medi-Cal website.


Wi-Fi will not be provided at the seminar. Please plan accordingly.

Providers who require more in-depth claim and billing information have the option to receive one-on-one claims assistance, which is available at all seminars in the Claims Assistance Room.

Providers may also schedule a custom billing workshop. On the Lookup Regional Representative Web page, enter the ZIP code for the area you wish to search and click the “Enter ZIP Code” button. The name of the designated field representative for your area will appear on the map. To contact a regional representative, providers must first contact the Telephone Service Center (TSC) at 1-800-541-5555 and request to be contacted by a regional representative.

Providers are encouraged to bookmark the Provider Training Web page and refer to it often for current seminar information.

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