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EPSDT Home Health Code Conversion: Notice of Implementation

January 17, 2019

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) home health code conversion initially announced in the August 2018, Medi-Cal Update,implemented on January 1, 2019.

Effective for dates of service on or after January 1, 2019, the EPSDT home health code conversion replaced non-HIPAA compliant HCPCS Level III codes with HIPAA-compliant CPT Category I and HCPCS Level II national codes.

The following resources for the EPSDT home health code conversion are located on the HIPAA: Code Conversions page under the EPSDT Services: Home Health heading:

  • EPSDT Home Health Code Conversion and Billing Instructions
  • EPSDT Home Health Code Conversion Frequently Asked Questions (FAQs)
  • Provider Readiness Checklist: EPSDT Home Health Code Conversion
  • EPSDT Home Health Code Conversion: TAR/eTAR and SAR/eSAR Policy Notice
  • EPSDT Home Health Code Conversion: Technical Publications and Support
  • EPSDT Home Health Services Local Code Conversion Webinars

For additional information, providers are encouraged to:

  • Watch for EPSDT home health 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 home health services.
  • View the computer based training, developed specifically for the EPSDT home health code conversion, located on the Medi-Cal Learning Portal.
  • Request additional onsite or telephone support via 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 from 8 a.m. to 5 p.m. Monday through Friday, except holidays.
  • Submit additional questions via email to CAMMISCodeConversion@conduent.com