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Medi-Cal Update

Clinics and Hospitals | October 2020 | Bulletin 553

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1. COVID-19 Quantitative Antibody Test Added as a Medi-Cal Benefit

Effective for dates of service on or after September 8, 2020, CPT® code 86413 (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease (COVID-19)] antibody, quantitative) is added as a Medi-Cal benefit.

CPT code 86413 may be billed with any ICD-10-CM code.

An Erroneous Payment Correction (EPC) will be processed for affected claims.

2. October 2020 HCPCS Quarterly Update

The October 2020 updates to the Healthcare Common Procedure Coding System (HCPCS) codes are available in the October 2020 HCPCS Policy Updates PDF.  Only those codes representing current or future Medi-Cal benefits are included in the list of updates.

The code additions, changes and deletions are effective for the dates of service on or after October 1, 2020. Please refer to the 2020 HCPCS code book for complete code descriptions.

Provider Manual(s) Page(s) Updated
AIDS Waiver Program
Audiology and Hearing Aids
Durable Medical Equipment
Home Health Agencies/Home and Community-Based Services
Medical Transportation
Orthotics and Prosthetics
Therapies
Vision Care
medi non hcp (2); modif app (13, 26)
Chronic Dialysis Clinics inject cd list (3, 4, 6, 9, 13, 15, 18, 20); inject drug a-d (17, 18, 25, 26); inject drug e-h (15, 16); inject drug i-m (26); medi non hcp (2); modif app (13, 26); modif used (5, 6, 12–15)
General Medicine
Clinics and Hospitals
chemo drug a-d (30, 31); chemo drug e-o (20, 29); chemo drug p-z (7–9, 20–23); inject cd list (3, 4, 6, 9, 13, 15, 18, 20); inject drug a-d (17, 18, 25, 26); inject drug e-h (15, 16); inject drug i-m (26); medi non hcp (2); modif app (13, 26); modif used (5, 6, 12–15); non ph (10, 13–15, 25, 27); ophthal (24); presum bill (12, 14–16); radi dia (21–25); surg digest (7); surg integ (4, 6); surg urin (5, 7)
Heroin Detoxification
Hospice Care Program
Psychological Services
medi non hcp (2)
Local Educational Agency modif app (13, 26)
Obstetrics inject cd list (3, 4, 6, 9, 13, 15, 18, 20); inject drug a-d (17, 18, 25, 26); inject drug e-h (15, 16); inject drug i-m (26); medi non hcp (2); modif app (13, 26); modif used (5, 6, 12–15); non ph (10, 13–15, 25, 27); presum bill (12, 14–16); radi dia (21–25); surg urin (5, 7)
Pharmacy inject cd list (3, 4, 6, 9, 13, 15, 18, 20); inject drug a-d (17, 18, 25, 26); inject drug e-h (15, 16); inject drug i-m (26); medi non hcp (2); presum bill (12, 14–16)
Rehabilitation Clinics inject cd list (3, 4, 6, 9, 13, 15, 18, 20); inject drug a-d (17, 18, 25, 26); inject drug e-h (15, 16); inject drug i-m (26); medi non hcp (2); modif app (13, 26); modif used (5, 6, 12–15); non ph (10, 13–15, 25, 27)

3. Medi-Cal Business Operations Fiscal Intermediary Name Change

Effective October 1, 2020, providers may notice that the Department of Health Care Services (DHCS) California Medicaid Information System (CA-MMIS) Fiscal Intermediary (FI) for the Medi-Cal program, formerly DXC, LLC, is operating under a new company name, “Gainwell Technologies.” Operations and interactions with providers are not impacted by this FI name change. There are no changes in the telephone numbers used by providers, including the Telephone Service Center (TSC) number (1-800-541-5555), as a result of this name change. The mailing addresses used by providers to conduct business with DHCS and the FI will remain the same as well.

4. Fiscal Intermediary Technology Refresh Implementation

As previously announced in a July 16, 2020 article, DXC Technology, the Business Operations Fiscal Intermediary (FI), has staged the deployment of various business oriented IT solutions to occur July 2020 onward.

As of August 2020, the following technological refreshes have already been implemented:

  • Print and Mail – Print and mailing solution for outbound communications, including provider welcome packets and provider letters

  • Member Card – Member card production solution for Beneficiary Identification Card (BIC) and Health Access Program (HAP) card production

  • Learning Management System – Also known as the Medi-Cal Learning Portal (MLP), this solution manages and houses training for internal and external users (e.g. providers, billers)

On September 14, 2020, the remaining technological refreshes are scheduled to be live in production:

  • Imaging/Optical Character Recognition (OCR) – Enables the processing of paper documents, including paper Treatment Authorization Requests (TARs), paper claims and correspondence

  • Records Repository – Houses the scanned images of paper documents received, including provider correspondence, claims and attachments

  • Telecommunications Infrastructure – Structure required to support the call platform and telephony solutions required for customer service call center operations

  • Customer Relationship Management – Provider and member contact ticketing solution used to manage, track and measure customer service

  • Interactive Voice Response – Voice response solution used to support provider self-service features, including the Automated Eligibility Inquiry Verification (AEVS) and the Provider Telecommunications Network

  • Medi-Cal Subscription Services (MCSS) – Provider/external party solution used to communicate information, such as System Status Alerts, news articles and provider manual updates

As with the initial operational transition in October 2019, and the first wave of technical changes in August 2020, the primary objective is a successful transition without disruption to state programs, providers and/or members (beneficiaries). Given the type of IT services slated for the second wave of technological changes, providers and members may notice differences in processes and/or may experience longer call wait times pre- and post-implementation as the operations prepare for deployment and stabilize.

The Department of Health Care Services (DHCS) will continue to provide updates as this effort progresses. Please continue to monitor the Medi-Cal Provider website for future updates on this topic.

5. CCS and GHPP Service Code Groupings Update

The following codes will be added to the California Children’s Services (CCS) Service Code Groupings (SCGs).

Added Codes
Effective Date Codes SCGs
January 1, 2020 CPT® codes 76391, 76978, 76979, 76981 thru 76983, 77046 thru 77049, 78429 01, 02
January 1, 2020 CPT codes 46948, 78430 thru 78835, 81173, 81174, 81177 thru 81190, 81204, 81234, 81236, 81237, 81239, 81277, 81284 thru 81286, 81289, 81305, 81306, 81329, 81336, 81337, 81343 thru 81345, 81443, 81596, 82642, 83722, 87563, 90619, 93264, 93356, 95700, 95705 thru 95726, 95782, 95783, 95836, 95976, 95977, 95983, 95984, 99458, 99473, 99474
HCPCS code A9513
01, 02, 03
January 1, 2020 CPT codes 10004 thru 10012, 15769, 15771 thru 15774, 20560, 20561, 20700 thru 20705, 36572, 36573, 38531, 43762, 43763, 49013, 49014, 62328, 62329, 64451, 64454, 64624, 64625, 74221, 74248, 87633, 90689, 90694, 92549, 99421 thru 99423, 99451 thru 99454, 99457, 99491
HCPCS codes A4216, A9590, J0121, J0122, J0185, J1095, J3304
01, 02, 03, 07
January 1, 2020 CPT codes 11102 thru 11107 01, 02, 03, 07, 12
January 1, 2020 CPT code 27369 01, 07
January 1, 2020 HCPCS code A9589 02
January 1, 2020 CPT codes 33016 thru 33019, 33274, 33275, 33285, 33286, 33289, 50436, 50437 02, 03
January 1, 2020 CPT codes 35702, 35703 02, 03, 07
January 1, 2020 CPT codes 96130 thru 96133 HCPCS code J1454 03
January 1, 2020 CPT codes 96112, 96113, 96121 03, 05, 06
January 1, 2020 CPT codes 20932 thru 20934 HCPCS code C9038 07
January 1, 2020 CPT codes 93985, 93986 09
January 1, 2020 CPT codes 66987, 66988, 99201, 92202, 92273, 92274 HCPCS codes C9034, G2102 thru G2104, J0179, J1096, J1097, J2797 10

Reminder: SCG 02 includes all the codes in SCG 01, plus additional codes applicable only to SCG 02. SCG 03 includes all the codes in SCG 01 and SCG 02, plus additional codes applicable only to SCG 03. SCG 07 includes all the codes in SCG 01 plus additional codes applicable only to SCG 07.
Provider Manual(s) Page(s) Updated
Audiology and Hearing Aids
Chronic Dialysis Clinics
Clinics and Hospitals
Durable Medical Equipment
General Medicine
Home Health Agencies/Home and Community-Based Services
Inpatient Services
Local Educational Agency
Medical Transportation
Obstetrics
Orthotics and Prosthetics
Pharmacy
Psychological Services
Rehabilitation Clinics
Therapies
Vision Care
cal child ser (1, 2, 4, 8–17, 21–25, 28, 31, 33, 36–38, 46–49, 52)

6. Updates to Policy for Injection Codes

Effective for dates of service on or after November 1, 2020, policy has been revised for HCPCS codes J0584 (injection, burosumab-twza, 1 mg) and J3397 (injection, vestronidase alfa-vjbk, 1 mg). The indications, dosage, Treatment Authorization Request (TAR) requirement criteria, age limits, ICD-10-CM diagnosis code requirements and prescribing restrictions have been revised for both codes.

Provider Manual(s) Page(s) Updated
Chronic Dialysis Clinics
Clinics and Hospitals
General Medicine
Obstetrics
Rehabilitation Clinics
inject drug a-d (28–30); inject drug s-z (21–23)

7. Updated Policy Effective Date for Billing Immune Globulins

Superseding communication from the Department of Health Care Services (DHCS) in the July 2020 General Bulletin, new changes are introduced for billing and claims submission of various HCPCS Level II and Current Procedural Terminology (CPT®) codes for Physician Administered Drugs (PAD).

As part of ongoing efforts to ensure consistency and accuracy in billing and provider reimbursements, providers must note the following when submitting claims for specific biologicals and drugs.

Preferred Codes for Billing Biologicals With both CPT and HCPCS Codes:

The biologicals below are billed with both CPT and HCPCS codes. The HCPCS codes are often more specific than the CPT codes. Now effective for dates of service on or after October 1, 2019, for reimbursement, providers must submit claims for the listed CPT codes using the corresponding HCPCS codes as shown in the table below:

Procedure Codes Procedure Descriptions Code(s) to Bill with
90281 Immune globulin (Ig), human, for intramuscular use J1460 or J1560
90283 Immune globulin (IgIV), human, for intravenous use J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572 or J1599
90284 Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each Bill J1555 (Cuvitru) & J1559 (Hizentra)

Continue to bill 90284 for all other immune globulins used for subcutaneous infusions
90291 Cytomegalovirus immune globulin (CMV-IgIV), human, for intravenous use J0850
90384 Rho(D) immune globulin (RhIg), human, full-dose, for intramuscular J2790 or J2791
90385 Rho(D) immune globulin (RhIg), human, mini-dose, for intramuscular use J2788
90386 Rho(D) immune globulin (RhIgIV), human, for intravenous use J2791 or J2792
90389 Tetanus immune globulin (TIg), human, for intramuscular use J1670

Providers may continue to bill for Gammagard liquid, Gammaked, Gammunex-C, Cutaquig and Xembify with CPT code 90284.

Cuvitru must be billed with J1555 and Hizentra with J1559.

Processes for Rebilling and Payment Correction of Rho (D) Immune Globulins for Dates of Service On or After October 1, 2019 to August 31, 2020 for Providers Who Billed With CPT Codes and Were Denied or Underpaid:

For providers who previously billed with CPT codes 90384 and 90385 and claims were denied:

  • Rebill with the corresponding J codes as indicated in the table above.

    • It is not necessary to submit a Treatment Authorization Request (TAR).

    • This ensures that providers are reimbursed at the full Medi-Cal rate available.

      • If rebill is submitted beyond the 6-month billing limitation, timeliness of the rebill is waived.

For providers who billed with CPT codes 90384 and 90385 and were reimbursed only the injection administration fee of $4.46:

  1. Submit a Claims Inquiry Form (CIF) to void the claim billed with the CPT code.
    • There is no time restriction on this process.

    • When completing the CIF, providers must enter the information exactly as it appears on the Remittance Advice Details (RAD) to ensure the claim is located within the claims processing system.

  2. Rebill using the corresponding J code as indicated in the table above for appropriate reimbursement following the void of the CPT code.

    • These steps ensure that providers are paid at the full Medi-Cal rate available.

    • It is not necessary to submit a TAR.

      • If rebill is submitted beyond the 6-month billing limitation, timeliness of the rebill is waived.

Instructions regarding the submission of CIF can be found here in the Billing Basics Outreach & Education workbook.

Erroneous Payment Correction (EPC) for Dates of Service from August 1, 2020 to August 31, 2020

  • EPCs are processed for all claims billed with J-codes, which were inappropriately denied for dates of service from August 1, 2020, to August 31, 2020.

    • EPCs are processed automatically. No action is required on the part of providers.

8. New Benefits: Magnetoencephalography (MEG) and Magnetic Source Imaging (MSI)

Effective for dates of service on or after November 1, 2020, CPT codes 95965 (magnetoencephalography [MEG], recording and analysis; for spontaneous brain magnetic activity), 95966 (magnetoencephalography [MEG], recording and analysis; for evoked magnetic fields, single modality), and 95967 (magnetoencephalography [MEG], recording and analysis; for evoked magnetic fields, each additional modality) and HCPCS code S8035 (magnetic source imaging) are added as Medi-Cal benefits.

An approved Treatment Authorization Request (TAR) indicating the procedure is for pre-operative brain mapping or epilepsy surgery is required

Provider Manual(s) Page(s) Updated
Chronic Dialysis Clinics modif used (10)
Clinics and Hospitals
General Medicine
medne neu (11); modif used (10); presum bill (10, 16); radi dia (18–19); tar and non cd9 (18)
Obstetrics modif used (10); presum bill (10, 16); radi dia (18–19); tar and non cd9 (18)
Inpatient Services tar and non cd9 (18)
Pharmacy presum bill (10, 16)
Rehabilitation Services modif used (10)

9. Reimbursement Rate Update for Electroencephalography Procedure

Effective for dates of service on or after January 1, 2020, the following procedure code rates for electroencephalography have been updated:

Procedure Code Procedure Description Current Medi-Cal Rate Basic Rate
95700 Electroencephalogram (EEG) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by EEG technologist, minimum of 8 channels $0.00 $296.98
95705 Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2–12 hours; unmonitored $0.00 $270.57
95706 Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2–12 hours; with intermittent monitoring and maintenance $0.00 $402.35
95707 Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2–12 hours; with continuous, real-time monitoring and maintenance $0.00 $780.43
95708 Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12–26 hours; unmonitored $0.00 $323.25
95709 Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12–26 hours; with intermittent monitoring and maintenance $0.00 $718.07
95710 Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12–26 hours; with continuous, real-time monitoring and maintenance $0.00 $1,247.78
95711 Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2–12 hours; unmonitored $0.00 $270.57
95712 Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2–12 hours; with intermittent monitoring and maintenance $0.00 $455.03
95713 Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2–12 hours; with continuous, real-time monitoring and maintenance $0.00 $889.74
95714 Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12–26 hours; unmonitored $0.00 $323.25
95715 Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12–26 hours; with intermittent monitoring and maintenance $0.00 $796.64
95716 Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12–26 hours; with continuous, real-time monitoring and maintenance

$0.00

$1,426.55

An erroneous payment correction (EPC) will be implemented to reprocess any affected claims.

10. Changes to Eligibility Requirements for Pulmonary Rehabilitation

Effective for dates of service on or after November 1, 2020, eligibility requirements for reimbursement of HCPCS code G0424 (pulmonary rehabilitation, including exercise [includes monitoring], 1 hour, per session, up to two sessions per day) are updated.

Previously, reimbursement for code G0424 was limited to patients 18 years of age and older. There is no longer a minimum age requirement for reimbursement. Additionally, patients eligible for lung transplant are now eligible for outpatient pulmonary rehabilitation.

Providers may now use ICD-10-CM diagnosis codes Z76.82 or Z94.2 to bill for HCPCS code G0424.

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
Durable Medical Equipment
General Medicine
Rehabilitation Clinics
Therapies
respir (7–9)

11. Policy Update for Sinuva Sinus Implant

Effective for dates of service on or after November 1, 2020, providers should only use HCPCS code C9122 (mometasone furoate sinus implant [Sinuva]),10 mcg) when billing for Sinuva sinus implants. Previously, providers were also able to use HCPCS code J7401 (mometasone furoate sinus implant, 10 mcg). Code J7401 will now only be used to bill for Propel sinus implants.

Provider Manual(s) Page(s) Updated
Chronic Dialysis Clinics
Clinics and Hospitals
General Medicine
Obstetrics
Pharmacy
Rehabilitation Clinics
inject cd list (16); inject drug i-m (33–35)

12. July 2020 NCCI Updates with Announced Correction

The Centers for Medicare and Medicaid Services (CMS) updated payment policy as part of the National Correct Coding Initiative (NCCI) Quarterly Updates for July 2020. The mandatory national edits were incorporated into the Medi-Cal claims processing system and were effective for dates of service on or after July 1, 2020.

Upon release, the Medically Unlikely Edit (MUE) values and MUE Adjudication Indicators (MAI) were inaccurate for the following HCPCS codes. CMS issued replacement MUE Quarter 3 2020 files for Practitioners (PRA) and Outpatient providers (OPH) retroactive to July 1, 2020.

  • G2078 (take-home supply of methadone; up to 7 additional day supply (provision of the services by a Medicare-enrolled opioid treatment program)

  • G2079 (take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a Medicare-enrolled opioid treatment program)

Providers may refer to The National Correct Coding Initiative in Medicaid page of the Medicaid website for information.

No action is required of providers. An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims.

13. Administrative Hearings to be Conducted by Telephone or Video Conference

The Office of Administrative Hearings and Appeals (OAHA) will conduct informal reviews, pre-hearing matters, settlement conferences, formal hearings and other matters via telephone or video conference, while Executive Orders N-55-20 and N-63-20 are in effect. The Department of Health Care Services (DHCS) recently issued guidance on timeframe extensions and data submittal deadlines for audits, and updates to administrative hearing timelines and processes, available on the DHCS website. For questions regarding this guidance, please email the OAHA inbox at OAHAmailbox@dhcs.ca.gov.

14. Authorized Drug Manufacturer Labeler Codes Update

The Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes section has been updated as follows.

Additions, effective October 1, 2020
NDC Labeler Code Contracting Company's Name
11788 AIPING PHARMACEUTICAL, INC.
42667 ACERUS PHARMACEUTICALS CORPORATION
69751 EVOFEM BIOSCIENCES, INC.
69880 CHIASMA, INC
69967 ARISE PHARMACEUTICALS LLC
70868 KEY THERAPEUTICS, LLC
72677 VIELA BIO, INC.
73302 HRA PHARMA AMERICA, INC.
73535 MORPHOSYS US INC.
Terminations, effective October 1, 2020
NDC Labeler Code Contracting Company's Name
00029 GLAXOSMITHKLINE
00091 SCHWARZ PHARMA, INC.
10511 PHOTOCURE, INC.
10888 BANNER PHARMACAPS INC.
13632 ROSEMONT PHARMACEUTICALS, LTD.
15127 SELECT BRAND DISTRIBUTORS
24856 THROMBOGENICS INC.
31357 INSPIRE PHARMACEUTICALS, INC.
43773 SLATE PHARMACEUTICALS, INC.
53097 THE PHARMA NETWORK, LLC
63717 HAWTHORN PHARMACEUTICALS
70403 ARU PHARMA INC.
70752 QUAGEN PHARMACUETICALS LLC
71717 MEGALITH PHARMACEUTICALS INC.

Provider Manual(s) Page(s) Updated
Adult Day Health Care Centers
AIDS Waiver Program
Chronic Dialysis Clinics
Clinics and Hospitals
Expanded Access to Primary Care Program
General Medicine
Heroin Detoxification
Home Health Agencies/Home and Community-Based Services
Hospice Care Program
Multipurpose Senior Services Program
Obstetrics
Pharmacy
Rehabilitation Clinics
drugs cdl p5 (2, 5–8, 10, 17–22)

15. Medi-Cal Rx Portal Registration Launched for Pharmacy Providers and Prescribers

The Department of Health Care Services (DHCS) continues to make significant towards a successful transition of pharmacy services on January 1, 2021 to Medi-Cal Rx.

To help facilitate a smooth and effective transition for Medi-Cal providers, beneficiaries, and other interested parties, DHCS has taken proactive steps to deploy a robust and multi-faceted outreach campaign, which includes, developing comprehensive beneficiary notices, developing call center scripts, conducting targeted provider outreach and providing for and advertising publicly various training opportunities available starting in October and continuing through the end of the year.

Additional activities include developing a dedicated Medi-Cal Rx website with secure portal components for Medi-Cal providers, health plans, beneficiaries and other interested parties.

Recently, DHCS launched the dedicated Medi-Cal Rx secure web portal, https://medi-calrx.dhcs.ca.gov/home/, and a registration page for Medi-Cal provider access, including but not limited to physician prescribers and pharmacies. This registration is the first step in the process for pharmacies and prescribers to use the Medi-Cal Rx secure web portal andits web-based tools for pharmacy services. For detailed registration and training instructions, access the Medi-Cal Rx Web Portal and Training Registration article located on the Pharmacy News Page (https://medi-calrx.dhcs.ca.gov/provider/pharmacy-news).

Access to the Medi-Cal Rx secure web portal will include key functions such as:

  • Web Claims Submission, Activities, and Inquiries

  • Beneficiary Eligibility Look Up

  • Prior Authorization Information and Submission

Other functions within the Web Portal include:

  • Learning Management System (LMS) for pharmacy and prescriber trainings

  • Message Center

  • Provider Survey

  • Password Management

  • Secure Chat

DHCS reminds Medi-Cal providers, health plans, beneficiaries and other interested parties that it is very important registration be completed early so user training and access are complete and active by January 1, 2021. Doing so will help to remove any potential challenges for successful utilization of the Medi-Cal Rx secure web portal.

The entire dedicated Medi-Cal Rx website will be fully operational by January 1, 2021. In the meantime, DHCS encourages Medi-Cal pharmacy providers and prescribers, health plans, beneficiaries, and other interested parties to sign up for the Medi-Cal Rx Subscription Service, which allows interested parties to receive Medi-Cal Rx updates in near real-time by email.

For general project questions and/or comments, please visit the DHCS website or email RxCarveOut@dhcs.ca.gov. In addition, DHCS encourages stakeholders to review the Medi-Cal Rx Frequently Asked Questions (FAQ) document, which continues to be updated as the project advances.

16. Average Selling Price Update for Blood Factors

Effective for dates of service on or after October 1, 2020, Esperoct® is billable under HCPCS code J7204 (injection, Factor VIII, antihemophilic factor [recombinant], [Esperoct], glycopegylated-exei, per IU).

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
General Medicine
blood (3); non ph (15, 29)
Obstetrics
Rehabilitation Clinics
non ph (15, 29)
Chronic Dialysis Clinics
Pharmacy
blood (3)

17. National Correct Coding Initiative Quarterly Update for October 2020

The Centers for Medicare & Medicaid Services (CMS) has released the quarterly National Correct Coding Initiative (NCCI) payment policy updates. These mandatory national edits have been incorporated into the Medi-Cal claims processing system and are effective for dates of service on or after October 1, 2020.

For additional information, refer to The National Correct Coding Initiative in Medicaid page of the Medicaid website.

18. Get the Latest Medi-Cal News: Subscribe to MCSS Today

The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails shortly after urgent announcements and other updates post on the Medi-Cal website.

Subscribing is simple and free!

  1. Go to the MCSS Subscriber Form

  2. Enter your email address and ZIP code and select a subscriber type

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

After submitting the form, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, please visit the MCSS Help page.

19. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:



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