Medi-Cal: Publications

General Medicine - Latest News

All Provider News

Title

Category

Publish Date

2022 HCPCS Quarter 3 Update

HCPCS

06/30/2022

Walk-Up Claims Discontinued

Medi-Cal will no longer accept walk-up claims. Providers will need to submit claims through mail or electronic submissions.

Billing

06/30/2022

SFY 2022-2023 DRG Grouper Settings documents will be updated to reflect 3M Grouper software update.

Billing

06/30/2022

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

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