Publish Date
Medi-Cal Coverage of Community Health Worker (CHW) Services is Effective July 1, 2022
Effective July 1, 2022, Medi-Cal covers Community Health Workers (CHW) services, including violence prevention services and asthma preventive services. This NewsFlash contains information describing the CHW benefit, including billing codes and rates.
Coming Soon: COVID-19 Vaccine for Children 6 Months and Up
Coming Soon: FDA amended EUA to allow COVID-19 vaccines for individuals 6 months and older.
DHCS Notice
Pfizer COVID-19 Vaccine Booster Dose Approved for Individuals 5 to 11 Years Old
Pfizer booster approved for individuals 5 to 11 years old.
2022 COVID-19 Vaccine Administration FAQs
A FAQ has been created regarding COVID-19 vaccine administration.
National Correct Coding Initiative Quarterly Update for July 2022
The Centers for Medicare & Medicaid Services (CMS) has incorporated the quarterly National Correct Coding Initiative (NCCI) Q1 2022 payment policy update into the Medi-Cal claims processing system.
Fiscal Year 2021-2022 Two-Week Checkwrite Hold for Specific Provider Payments
Specific checkwrites scheduled in June for fiscal year 2021 – 2022 will be delayed until the start of 2022 – 2023.
EWC Mammography Screening Age Restrictions Update
CPT code 77067 now a billable procedure for women under age 40 who are at high risk for breast cancer.
Every Woman Counts
Postpartum Care Expansion for Medi-Cal and MCAP Beneficiaries
An individual eligible for pregnancy and postpartum care services under MCAP is entitled to an additional ten months postpartum coverage at the end of their 60-day postpartum period for a total 12 months of postpartum coverage.
Medi-Cal Subscription Service (MCSS) is Live
Announcement that MCSS is back online, outlining what has changed and suggesting actions to take to ensure email receipt.
DHCS Notice
Second Booster Dose for Select COVID-19 Boosters Now a Benefit
Updates that allow providers to bill second booster shot and clarify policy for procedure codes 0004A, 0034A, 0054A, 0064A.
Antiretroviral Ibalizumab-uiyk Injection Available for Managed Care Plans
HCPCS code J1746 is a capitated service for CalOptima and Health Plan of San Mateo but non-capitated for all other Manage Cared Plans.
DHCS Notice
Available Sessions for the June Virtual Claims Assistance Room (CAR) Event
A reminder that one-on-one billing assistance appointments are available to join the Virtual Claims Assistance Room (CAR) event in June.
Outreach and Education
Reporting Procedure for Intermittent Clinics and Mobile Health Units
Update to reporting procedure for new or converted intermittent clinics and mobile health units pursuant to W&I Code Section 14043.15(e).
Provider Enrollment
CHDP Gateway Program 2022 Income Eligibility Guidelines
Effective January 1, 2022, through December 31, 2022, providers are to use the 2022 Federal Poverty Level Guidelines when determining recipient eligibility for pre-enrollment in Medi-Cal through the CHDP Gateway program.
DHCS Notice
2022 Income Eligibility Guidelines for PE4PW
Article notifying providers of updates to presum and presum proc MRPs updating the Federal Poverty Level guidelines for PE4PW for 2022.

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