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

Part 2 – Home Health Agencies/Home and Community-Based Services (HOM)

106,894 Bytes206,336 Bytes

Medi-Cal Program (00medi-cal)

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Medi-Cal Provider Manual Contents

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Manual Organization (0Amanorg)

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How to Use This Manual (0Bhwtouse)

19,786 Bytes80,384 Bytes

Getting Started: Where to Find the Answers D (0C get start)

10,682 Bytes39,424 Bytes

Contents (Part 2 – Medi-Cal Billing and Policy): HHA and HCBS (2toc hom)

110,276 Bytes161,792 Bytes

Appeal Form Completion (appeal form)

15,469 Bytes51,712 Bytes

California Children's Services (CCS) Program (cal child)

5,600 Bytes32,768 Bytes

California Children’s Services (CCS) Program Approved Hospitals (cal child appr)

6,830 Bytes35,328 Bytes

California Children's Services (CCS) Program Billing (cal child bil)

6,747 Bytes38,912 Bytes

CCS Program Billing Guidelines (cal child bil guide)

48,780 Bytes77,824 Bytes

California Children's Services (CCS) Program Billing Example: UB-04 Claim Form (cal child bil ub)

20,850 Bytes112,128 Bytes

California Children’s Services (CCS) Program County Office Directory (cal child county)

10,560 Bytes49,664 Bytes

California Children's Services (CCS) Program Eligibility (cal child elig)

9,495 Bytes34,304 Bytes

California Children's Services (CCS) Program Medical Therapy Program (cal child med)

36,132 Bytes67,072 Bytes

California Children's Services (CCS) Program Provider Paneling (cal child panel)

16,759 Bytes90,624 Bytes

Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Physicians and Podiatrists (DHS 4514)

20,274 Bytes102,912 Bytes

Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Allied Health Care Professionals (DHS 4515 )

12,914 Bytes72,704 Bytes

California Children's Services (CCS) Program Referrals (cal child ref)

23,827 Bytes94,208 Bytes

California Children's Services (CCS) Program Service Authorization Request (SAR) (cal child sar)

66,879 Bytes322,560 Bytes

California Children’s Services (CCS) Program Service Code Groupings (cal child ser)

4,199 Bytes26,624 Bytes

California Children’s Services (CCS) Program Special Care Centers (cal child spec)

125,697 Bytes212,992 Bytes

CIF Completion (cif co)

115,215 Bytes173,568 Bytes

CIF Special Billing Instructions for Outpatient Services (cif sp op)

63,483 Bytes100,352 Bytes

CIF Submission and Timeliness Instructions (cif sub)

55,491 Bytes602,112 Bytes

Drugs: Contract Drugs List Part 5 – Authorized Manufacturer Labeler Codes (drugs cdl p5)

13,404 Bytes43,520 Bytes

Forms: Legibility and Completion Standards (forms leg)

9,276 Bytes31,744 Bytes

Forms Reorder Request: Guidelines (forms reo)

35,141 Bytes72,704 Bytes

Forms Reorder Request: Inpatient and Outpatient Services (forms reo io)

29,644 Bytes113,664 Bytes

Genetically Handicapped Persons Program (GHPP) (genetic)

9,899 Bytes32,768 Bytes

HCPCS Introduction (hcpcs)

11,603 Bytes59,904 Bytes

HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes (hcpcs iii)

17,450 Bytes66,048 Bytes

Home and Community-Based Services (HCBS) (home)

27,473 Bytes223,744 Bytes

Home and Community-Based Services (HCBS) Billing Codes and Reimbursement Rates (home cd)

18,038 Bytes71,680 Bytes

Home Health Agencies (HHA) (home hlth)

12,786 Bytes63,488 Bytes

Home Health Agencies (HHA) Billing Codes and Reimbursement Rates (home hlth cd)

616,011 Bytes855,040 Bytes

Home Health Agencies (HHA) Billing Examples (home hlth ex)

40,185 Bytes164,352 Bytes

Medicare/Medi-Cal Crossover Claims: Outpatient Services (medi cr op)

814,879 Bytes968,192 Bytes

Medicare/Medi-Cal Crossover Claims: Outpatient Services Billing Examples (medi cr op ex)

33,229 Bytes194,560 Bytes

Medicare/Medi-Cal Crossover Claims: Outpatient Services Medi-Cal Pricing Examples (medi cr op pr)

4,725 Bytes29,696 Bytes

Medicare Non-Covered Services: Charts Introduction (medi non cha)

14,943 Bytes68,608 Bytes

Medicare Non-Covered Services: HCPCS Codes (medi non hcp)

34,319 Bytes252,928 Bytes

Modifiers: Approved List (modif app)

14,889 Bytes52,736 Bytes

Other Health Coverage (OHC) (oth hlth)

11,907 Bytes48,640 Bytes

Other Health Coverage (OHC): CPT-4 and HCPCS Codes (oth hlth cpt)

16,857 Bytes64,000 Bytes

Pediatric Day Health Care (PDHC) - Early and Periodic Screening, Diagnosis and Treatment (ped)

11,654 Bytes39,936 Bytes

Physician-Administered Drugs: NDC (physician ndc)

18,357 Bytes58,880 Bytes

Physician-Administered Drugs – NDC: UB-04 Billing Instructions (physician ndc ub)

13,212 Bytes46,592 Bytes

Pregnancy: Postpartum and Newborn Referral Services (preg post)

11,854 Bytes43,520 Bytes

Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry) (prov bil)

10,070 Bytes52,224 Bytes

Remittance Advice Details (RAD) (remit adv)

28,129 Bytes183,296 Bytes

Remittance Advice Details (RAD) Examples: Outpatient Services (remit ex op)

10,322 Bytes35,328 Bytes

Remittance Advice Details (RAD): Payments and Claim Status (remit pay)

690,784 Bytes803,328 Bytes

Resubmission Turnaround Document (RTD) Completion (resub comp)

109,943 Bytes166,400 Bytes

Share of Cost (SOC): UB-04 for Outpatient Services (share op)

11,715 Bytes45,056 Bytes

Sign Language Interpretation (sign)

122,667 Bytes191,488 Bytes

TAR Completion (tar comp)

294,934 Bytes543,232 Bytes

TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer)

27,549 Bytes122,368 Bytes

TAR Field Office Addresses (tar field)

104,194 Bytes151,552 Bytes

TAR Submission: Transmittal Form (tar submis)

10,532 Bytes33,792 Bytes

TAR: Submitting Appeals (tar submit)

363,724 Bytes553,984 Bytes

UB-04 Completion: Outpatient Services (ub comp op)

24,781 Bytes61,952 Bytes

UB-04 Special Billing Instructions for Outpatient Services (ub spec op)

20,137 Bytes83,456 Bytes

UB-04 Submission and Timeliness Instructions (ub sub)

14,623 Bytes56,320 Bytes

UB-04 Tips for Billing: Outpatient Services (ub tips op)



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