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

January 28, 2019

The audiology, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) audiology and speech therapy code conversion replaces non-HIPAA-compliant HCPCS Level III codes, commonly referred to as local codes, with HIPAA-compliant CPT Category I national codes and/or HCPCS Level II codes. HIPAA mandated these changes to billing requirements for audiology, EPSDT audiology and speech therapy services.

Effective for dates of service on or after June 1, 2019, providers will bill claims using HIPAA-compliant HCPCS Level II and CPT Category I national codes with or without modifier(s).

Billing Instructions and Frequently Asked Questions (FAQs) will be available in the Audiology/EPSDT Audiology/Speech Therapy 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 audiology, EPSDT audiology and speech therapy services.
  • 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).

Submit all other questions about the audiology, EPSDT audiology and speech therapy code conversion via email to CAMMISCodeConversion@conduent.com