Medi-Cal: Publications

General Medicine - Latest News

All Provider News

Title

Category

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.

Billing

06/29/2022

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

06/28/2022

Pfizer COVID-19 Vaccine Booster Dose Approved for Individuals 5 to 11 Years Old

Pfizer booster approved for individuals 5 to 11 years old.

COVID-19

06/23/2022

2022 COVID-19 Vaccine Administration FAQs

A FAQ has been created regarding COVID-19 vaccine administration.

COVID-19

06/22/2022

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.

Claims

06/16/2022

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.

Billing

06/16/2022

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

06/09/2022

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.

COVID-19

06/08/2022

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

05/31/2022

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.

COVID-19

05/23/2022

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

05/20/2022

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

05/20/2022

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

05/09/2022

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.

Billing

05/09/2022

Hepatitis B Vaccine Code 90759 is Now a Medi-Cal Benefit

Hepatits B vaccine code 90759 is a Medi-Cal benefit for beneficiaries 18 years of age and older.

Billing

05/06/2022

Featured Links

Billing Tips

Links to important billing information

Computer Media Claims

CMC claims submission on the Internet

Frequently Asked Questions

Medi-Cal FAQs about policies, program and billing

Forms

Download Medi-Cal forms

HIPAA

Health Insurance Portability and Accountability Act information

Medi-Cal Rates

Monthly updated Medi-Cal rates

Navigating Medi-Cal and Specialty Health Programs

Bulletins and Manuals Navigation Tool

References

Medi-Cal references have an assortment of helpful materials and listings related to the Medi-Cal program