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

CHDP Phase 2 Reminder: Providers Must be Enrolled in Medi-Cal

May 15, 2017

The Child Health and Disability Prevention (CHDP) program’s HIPAA code conversion and transition to national claim forms will be implemented for claims with dates of service on or after July 1, 2017. This code conversion and transition will change how CHDP providers bill for CHDP Early and Periodic Screening, Diagnosis and Treatment (EPSDT) health assessment, immunization and laboratory services.

Reminder: 

Claims are processed based on a provider’s enrolled Medi-Cal location(s). If the business address on the claim does not match one of the business addresses on file in the claims processing system, the claim may be denied.

Medi-Cal Provider Enrollment
Providers who are not enrolled in Medi-Cal in active status must complete and submit an enrollment application. Application forms by provider type are available on the Application Packages by Provider Type Web page of the Department of Health Care Services (DHCS), Provider Enrollment Division website. Helpful information about provider enrollment is available on the Medi-Cal Provider Enrollment FAQs Web page. Some providers may be able to enroll in Medi-Cal through the Provider Application and Validation for Enrollment (PAVE) portal.

To update existing enrollment information, providers may be able to use the Medi-Cal Supplemental Changes form (DHCS 6209, Rev. 10/16), which must be submitted to the DHCS Provider Enrollment Division (PED). Providers can click on the preceding “Medi-Cal Provider Enrollment FAQs” link to find form DHCS 6209.

References
Facts about both CHDP transition Phase 1 and 2 are available on the CHDP Frequently Asked Questions page of the Medi-Cal website.

Providers are encouraged to watch for CHDP updates in the NewsFlash area on the Medi-Cal website, and subscribe to the Medi-Cal Subscription Service (MCSS) to receive timely notifications related to CHDP by completing the MCSS Subscriber Form.

Providers with questions or comments may call the Telephone Service Center (TSC) at 1-800-541-5555 from 8 a.m. to 5 p.m., Monday through Friday, except holidays.
Providers may submit questions or comments regarding the CHDP code conversion and claim form transition to CHDPTransition@conduent.com.