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Ivory Settlement Agreement and Private Duty Nursing Case Management Services

November 19, 2019

Providers may bill for private duty nursing (PDN) case management services rendered to Medi-Cal recipients. The recipient must be approved to receive PDN services under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit and must not be enrolled in the California Children’s Services (CCS) program, a Managed Care Plan (MCP) or the Home and Community-Based Services (HCBS) waiver. Providers may bill Medi-Cal with CPT codes 99490 and 99491 (chronic care management services) for approved PDN case management services. Updated manual pages will be released in a future Medi-Cal Update.