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

Medi-Cal Logo
Click to Sign Up for MCSS emails

Correction: Certification Statement Required for Medical Supply Invoice Attachments

June 22, 2017

This article corrects information published in the May 2017 Medi-Cal Update. Effective June 1, 2017, regardless of date of service, any medical supply claim with an invoice attachment for documentation of product cost that does not contain a certification statement will be denied with Remittance Advice Details (RAD) code 9556: Either the invoice or the certification is missing or invalid. The previous article is corrected below.

Effective June 1, 2017, the Department of Health Care Services (DHCS) is adopting a policy requiring a self-certification statement on all invoice attachments for medical supply claims. Providers are required to include the following certification statement exactly as written on all invoices and on each invoice page:

“I certify that I have properly disclosed and appropriately reflected a discount or other reduction in price obtained from a manufacturer or wholesaler in the costs claimed or charges on this invoice identified by item number _______________ as stated in 42 U.S.C. 1320a-7b (b) (3) (A) of the Social Security Act and this charge does not exceed the upper billing limit as established in California Code of Regulations Title 22, Section 51008.1 (a) (2) (D).”

The item claimed must be clearly identified on the invoice if the item number is not identified on the statement.