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New Pregnancy Aid Codes

November 4, 2016

Effective for dates of service on or after October 1, 2016, aid code 0G is added to the Medi-Cal Eligibility Verification System. Aid code 0G provides full-scope, no Share of Cost (SOC) health care services (medical, dental and vision), through Medi-Cal fee-for-service, to pregnant women who are California residents with a modified adjusted gross income (MAGI) above 213 percent and up to and including 322 percent of the federal poverty level (FPL).

Effective for dates of service on or after July 1, 2017, aid code 0E is added to the Medi-Cal Eligibility Verification System. Aid code 0E provides full-scope, no SOC health care services (medical, dental and vision), through Medi-Cal managed care delivery system, to pregnant women who are California residents with a MAGI above 213 percent and up to and including 322 percent of the FPL.

Both aid codes 0E and 0G are eligible for Local Educational Agency (LEA) services and Child Health and Disability Prevention (CHDP) services. These codes are not valid for an infant using the mother’s ID.

Note:

Claims submitted with 0E and 0G may experience temporary processing delays due to system updates.

Manual pages reflecting this policy will be released in a future Medi-Cal Update.