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Notice of HIPAA Code Conversion for Maternal Care Services and CPSP

December 6, 2018

The maternal care services and Comprehensive Perinatal Service Program (CPSP) code conversion replaces HCPCS Level III codes, commonly referred to as local codes, with HIPAA-compliant CPT Category I or HCPCS Level II national codes. HIPAA mandated these changes to the billing requirements for maternal care services and CPSP providers.

For claims with dates of service on or after April 1, 2019, providers will use a combination of revenue codes and CPT Category I or HCPCS Level II codes; or revenue codes and CPT Category I or HCPCS Level II codes with a modifier.

Billing instructions and Frequently Asked Questions (FAQs) will soon be available in the Maternal Care Services and CPSP section located on the HIPAA: Code Conversions web page.

Providers are encouraged to:

  • Routinely check the Medi-Cal Learning Portal Training Calendar for announcements of upcoming training and webinars developed specifically for maternal care and CPSP providers.
  • Watch for maternal care and CPSP updates in the NewsFlash area of the Medi-Cal website and in the monthly Medi-Cal Update provider bulletins.
  • Complete the Medi-Cal Subscription Service (MCSS) Form to receive timely notifications related to maternal care services and CPSP.

Providers may request additional onsite or telephone support via the Telephone Service Center (TSC) at 1-800-541-5555, from 8 a.m. to 5 p.m., Monday through Friday, except holidays. Border providers and out-of-state billers billing for in-state providers call (916) 636-1200. Providers calling from outside of California call the Out-of-State Provider Unit at (916) 636-1960.

For electronic claim submission questions, contact the TSC at 1-800-541-5555, select option “4” for the Technical Help Desk and option “2” for Computer Media Claims (CMC).

Submit all other questions about the maternal care services and CPSP code conversion via email to CAMMISCodeConversion@conduent.com.