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EPSDT Psychology, Mental and Behavioral Health Code Conversion Reminder

December 4, 2018

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Psychology, Mental and Behavioral Health code conversion replaces 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.

For claims with dates of service on or after April 1, 2019, providers will use a combination of:

  • CPT Category I codes with a modifier, or
  • Revenue codes and CPT Category I codes with a modifier.

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 section of the HIPAA: Code Conversions web page.
  • 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 Unit at (916) 636-1960 from 8 a.m. to 5 p.m., Monday through Friday, except holidays.
  • 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 for the EPSDT Psychology, Mental and Behavioral Health Code Conversion may be submitted via email to CAMMISCodeConversion@conduent.com.