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

EPSDT Psychology, Mental and Behavioral Health Services Code Conversion Reminder

October 26, 2018

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

Providers will use a combination of:

  • CPT Category I codes; with a modifier; or
  • Revenue codes and CPT Category I codes with a modifier

The effective date for this code conversion will be announced at a future date.

Providers are encouraged to watch for EPSDT psychology, mental and behavioral health service updates in the NewsFlash area of the Medi-Cal website and in the monthly Medi-Cal Update.

Providers may complete the Medi-Cal Subscription Service (MCSS) Form to receive timely notifications related to EPSDT psychology, mental and behavioral health services.

For additional information, providers may:

  • Visit the EPSDT Services: Psychology, Mental and Behavioral Health heading on the HIPAA: Code Conversions webpage.
  • 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).

All other questions about the EPSDT psychology, mental and behavioral health code conversion may be submitted via email to CAMMISCodeConversion@conduent.com.