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Notice of HIPAA Code Conversion for Audiology, EPSDT Audiology and Speech Therapy

November 27, 2018

The Audiology, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Audiology and Speech Therapy 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 billing requirements for audiology, EPSDT audiology and speech therapy services.

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 modifier(s).

Billing instructions and Frequently Asked Questions (FAQs) will soon be available in the Audiology/EPSDT Audiology/Speech Therapy section of the HIPAA: Code Conversions web page. Additional information for this project will publish as details are determined.

  • Providers are encouraged to refer to the Audiology, EPSDT Audiology and Speech Therapy Crosswalk for a full description of the HIPAA compliant CPT Category I or HCPCS Level II national codes and modifiers.
  • Routinely check the Medi-Cal Learning Portal (MLP) Provider Training Calendar for announcements of upcoming training and webinars developed specifically for Audiology and Speech Therapy providers.
  • Watch for audiology, EPSDT audiology and speech therapy 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 audiology, EPSDT audiology and speech therapy 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).

All other questions about the Audiology, EPSDT Audiology and Speech Therapy code conversion may be submitted via email to CAMMISCodeConversion@conduent.com.