Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Notice of EPSDT Psychology, Mental and Behavioral Health Code Conversion

February 15, 2019

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) psychology, mental and behavioral health services code conversion replaces non-HIPAA-compliant HCPCS Level III codes, commonly referred to as local codes, with HIPAA-compliant CPT national codes. HIPAA mandated these changes to billing requirements for EPSDT psychology, mental and behavioral health services.

Effective for dates of service on or after June 1, 2019, providers will bill claims using HIPAA-compliant CPT national codes.

Billing Instructions and Frequently Asked Questions (FAQs) will be available soon in the EPSDT Services: Psychology, Mental and Behavioral Health section of the HIPAA: Code Conversions web page.

Providers are encouraged to:

  • Routinely check the Medi-Cal Learning Portal (MLP) Provider Training Calendar for announcements of upcoming training and webinars developed specifically for EPSDT psychology, mental and behavioral health services.
  • Watch for EPSDT psychology, mental and behavioral health services updates on the Medi-Cal website in the NewsFlash area and in the monthly Medi-Cal Update provider bulletins.
  • Complete the Medi-Cal Subscription Service (MCSS) Form to receive timely notifications related to EPSDT psychology, mental and behavioral health services.

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 EPSDT psychology, mental and behavioral health services code conversion via email to CAMMISCodeConversion@conduent.com.