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Title
Category
Publish Date
2022 HCPCS Quarter 3 Update
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
Diagnosis Related Group State Fiscal Year 2022-2023 Grouper Setting Updates
SFY 2022-2023 DRG Grouper Settings documents will be updated to reflect 3M Grouper software update.
Billing
06/30/2022
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
Updated: TAR Criteria for Inpatient Services
Update TAR criteria for inpatient services and medical criteria for acute administrative days.
Programs
06/09/2022
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
2022 HPE Income Eligibility Guidelines
The Hospital Presumptive Eligibility program income eligibility guidelines have been updated for 2022. Providers must use the new guidelines when determining program eligibility.
Programs
05/09/2022
Medi-Cal Provider Website: Improvements to Transaction Services
The Medi-Cal Provider website will be updated to improve user experience. This update includes multiple subscriber eligibility application, removal of unused swipe card, eligibility response, and several minor bug fixes to various applications.
Enhancements and Operations
04/28/2022

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