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Reinstatement of End of Life Option Act Services in Medi-Cal

June 19, 2018

On June 14, 2018, the Department of Health Care Services (DHCS) issued a notice entitled “Suspension of End of Life Option Act Services in Medi-Cal.” At that time, DHCS suspended reimbursement for the provision of aid-in-dying drugs as a result of the judgment entered by the Riverside Superior Court in the case of Ahn, et al., v. Hestrin, et al., which invalidated the California End of Life Option Act (the Act). However, on June 15, 2018, the Fourth District Court of Appeal stayed the judgment of the Riverside Superior Court pending further proceedings. Thus, effective for dates of service on or after May 24, 2018, DHCS is reinstating reimbursement for the provision of aid-in-dying drugs billed with the following procedure and diagnosis codes:

Procedure and Diagnosis Code Claim Type Description of Service Billed By
HCPCS code
J7999 billed with ICD-10-CM Z76.89
CMS-1500 Compounded drug, not otherwise specified (NOS) Attending physicians, pharmacists
HCPCS code
J8499 billed with ICD-10-CM Z76.89
CMS-1500 Prescription drug, oral, non-chemotherapeutic, not otherwise specified (NOS) Attending physicians, pharmacists

Please note that claims previously submitted with the aforementioned procedure and diagnosis codes for dates of service on or after May 24, 2018 were not affected by the June 14, 2018 notice and do not need to be resubmitted. Providers may continue to check for updates regarding this policy on the Medi-Cal website.