Medi-Cal Update

AIDS Waiver Program | May 2018 | Bulletin 524

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1. A New Way to Subscribe – Contact Medi-Cal Subscription Service Representatives

Medi-Cal is committed to keeping you up-to-date on the latest Medi-Cal news and policy updates.

The Medi-Cal Subscription Service (MCSS) is a free service that provides subscribers with personalized email notifications for urgent, high-impact announcements and monthly news/policy updates as they post to the Medi-Cal website.

Providers can now contact MCSS representatives directly at MCSSCalifornia@conduent.com to subscribe and for assistance with managing subscriptions. Subscribing is simple and free!

If you have not yet subscribed to MCSS, Medi-Cal encourages you to utilize one of the following two methods to subscribe.

To subscribe by email:

  1. Download the linked MCSS Subscriber Form

  2. Enter your name, email address, ZIP code and subscriber type in the appropriate fields

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

  4. Attach your completed form to an email and send to MCSSCalifornia@conduent.com

To subscribe online:

  1. Go to the MCSS Subscriber Form page on the Medi-Cal website

  2. Enter your email address and ZIP code, and select a subscriber type from the drop-down menu

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

  4. Click “Subscribe Now” at the bottom of the page

After the form has been received, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, visit the MCSS Help page.

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2. Corrected Rate Update for AIDS Waiver Program

In a previous Medi-Cal Update published April 2018, the reimbursement rates for several HCPCS and CPT-4 codes were updated for the AIDS Medi-Cal Waiver Program (MCWP) in error. The correct reimbursement rates, effective retroactively for dates of service on or after July 1, 2017, are as follows:

  CPT-4 or HCPCS Code Description Maximum Rate
  90837 Psychotherapy, 60 minutes with patient $ 98.02
per hour
  90846 Family psychotherapy (without the patient present), 50 minutes 98.02
per hour
  90847 Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes 98.02
per hour
  G0156 Services of home health/hospice aide in home health or hospice settings (attendant care), each 15 minutes 9.52
per 15 minutes
  G0299 Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes 19.27
per 15 minutes
  G0300 Direct skilled nursing services of a license practical/vocational nurse (LPN/LVN) in the home health or hospice setting, each 15 minutes 13.97
per 15 minutes
  S5130 Homemaker service, nos; per 15 minutes 7.07
per 15 minutes
  S9470 Nutritional counseling, dietitian visit 63.61
per hour
  T2003 Non-emergency transportation; encounter/trip 100.00
per client per month
  T2022 Case management, per month 363.23
per client per month
  T2025 Waiver services; not otherwise specified (nos) 246.91
per client per month

An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. These rates are exclusive for AIDS MCWP.

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

Provider Manual(s) Page(s) Updated
AIDS Waiver Program aids (12–15, 18, 19); aids bil cd (1)
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3. Valid Revenue Codes for Outpatient Services

For dates of service on or after January 1, 2019, a four-digit revenue code must be included on outpatient claims billed on paper UB-04 claim forms (Box 42) or ANSI 837I transactions for electronic billing (FL42; reference ASC X12N 837 v.5010 Loop 2400 Segment SV201).

A revenue code identifies specific accommodations, ancillary services, or unique billing calculations or arrangements. As defined by the National Uniform Billing Committee (NUBC) and required by the HIPAA, services covered in an outpatient setting require a valid four-digit revenue code to accompany the CPT and HCPCS national procedure code(s).

Outpatient claims with dates of service on or after January 1, 2019, that are submitted on paper UB-04 claim forms or ANSI 837I transactions with missing, incomplete, or invalid revenue codes will be denied.

Providers may contact the Telephone Service Center (TSC) at 1-800-541-5555 for claims assistance.

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4. June 2018 Medi-Cal Provider Training Webinars

Beginning June 5, 2018, and continuing throughout the month of June, Medi-Cal providers may participate in provider training webinars:

Providers will be able to print class materials and ask questions during the training sessions. Recorded webinars will be archived and available for on-demand viewing from the MLP.

To view the webinars, providers must have Internet access and a user profile in the MLP. Detailed instructions about the registration process and how to access webinar classes are available on the Outreach & Education page of the Medi-Cal website.

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

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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 shortly after urgent announcements and other updates post on the Medi-Cal website.

Subscribing is simple and free!

  1. Go to the MCSS Subscriber Form

  2. Enter your email address and ZIP code and select a subscriber type

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

After submitting the form, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, please visit the MCSS Help page.

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6. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

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