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Medi-Cal Update

Clinics and Hospitals | April 2021 | Bulletin 559

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1. COVID-19 Testing: Billing Update for Medi-Cal COVID-19 Testing in Schools

Effective for dates of service on or after February 1, 2021, students in transitional kindergarten through the 12th grade, who are Medi-Cal beneficiaries, are eligible to receive coronavirus disease (COVID-19) clinical laboratory testing services, not including specimen collection services. These services are billable by eligible Medi-Cal providers when the service is provided in schools to students enrolled in Medi-Cal and in transitional kindergarten through the 12th grade.

When submitting a claim, eligible clinical laboratories and other eligible providers are required to indicate the location of the service for students enrolled in either Medi-Cal fee-for-service or managed care. Place of Service (POS) Code 03 is for schools. All COVID-19 testing services, when provided in a school and billed with POS Code 03, will be carved out from being a managed care benefit and will be reimbursed through the fee-for-service delivery system. Providers are reminded to utilize the Medi-Cal Benefits Identification Card (BIC) number when submitting claims to the fee-for-service claims processing system for students in the managed care delivery system. All existing allowable provider types for the COVID-19 test codes today will be eligible to bill for the tests provided in schools.

When the service is provided in a school, Medi-Cal will reimburse for the COVID-19 testing services at 100 percent of the corresponding Medicare rate for the same or similar service, in accordance with State Plan Amendment (SPA) 20-0024. These services, when provided in a school, will also be exempt from the ten percent payment reductions under Assembly Bill (AB) 97 (2011) and as codified in Welfare and Institutions Code (W&I Code) Section 14105.192.

Upon expiration of the public health emergency or national emergency, whichever occurs first, the COVID-19 testing reimbursement rates will be amended to correspond with the clinical laboratory services methodology in W&I Code Section 14105.22, including the application of the AB 97 payment reduction.

The provider billing guidance for COVID-19 testing services for POS Code 03 was published prior to implementation of the system changes necessary to support appropriate adjudication. Therefore, providers who submitted claims for these services were denied erroneously with Remittance Advice Details Code 0037 (Health Care Plan/Mental Health Care enrollee, capitated service not billable to Medi-Cal). An Erroneous Payment Correction (EPC) will be installed to reprocess these erroneously denied claims since the necessary system changes has been installed.

As system changes have been made, providers may elect use this updated billing policy to correct and resubmit previously denied claims as described in the CIF Submission and Timeliness Instructions section of the Provider Manual.

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
General Medicine
Obstetrics
path micro (9–12)

2. CCS 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 15, 2021 CPT Codes 87428, 87636, 87637, 87811 and HCPCS Code G2012 01, 02
January 15, 2021 CPT Codes 96158, 96159, 96164, 96165, 96167, 96168, 96170, 96171 02
January 15, 2021 HCPCS Codes L7510, L8621, L9900 04
January 15, 2021 HCPCS Code Q4081 09

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
Community-Based Services
Durable Medical Equipment
General Medicine
Home Health Agencies/Home and
Local Educational Agency
Inpatient Services
Medical Transportation
Obstetrics
Orthotics and Prosthetics
Pharmacy
Psychological Services
Rehabilitation Clinics
Therapies
Vision Care
cal child ser (1, 2, 21, 23, 32, 34, 46)

3. Medi-Cal Coverage Under the COVID-19 Public Health Emergency

Under the continuous coverage requirements in the federal Families First Coronavirus Response Act (FFCRA), all Medi-Cal beneficiaries are maintained in their current aid codes until end of the coronavirus disease 2019 (COVID-19) public health emergency (PHE). As a reminder, individuals in pregnancy-related aid codes continue to remain eligible for non-pregnancy services, as appropriate, under current COVID-19 PHE protections. Providers are advised to continue submitting claims with applicable diagnosis codes.

Questions concerning eligibility under pregnancy-related aid codes during PHE should be sent to pregnancy@dhcs.ca.gov.

4. New COVID-19 HCPCS Codes for the Every Woman Counts Program

Effective for dates of service on or after March 4, 2020, the Every Woman Counts Program (EWC) has added the following HCPCS codes as benefits for Primary Care and Referral Providers to align with existing coronavirus (COVID-19) Medi-Cal telehealth coverage policy:

G2010 (Remote evaluation of recorded video and/or images submitted by an established patient [e.g., store and forward], including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment).

G2012 (Brief communication technology-based service, e.g., virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5–10 minutes of medical discussion).

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
General Medicine
Obstetrics
ev woman (34–38)

5. 2021 HCPCS Q2 Update

The 2021 Quarter 2 updates to the Healthcare Common Procedure Coding System (HCPCS) codes are available in the HCPCS Policy Updates PDF. Only those codes representing current and past Medi-Cal benefits are included in the list of updates.

The code updates are effective for dates of service on or after April 1, 2021. Please refer to the HCPCS Level I and II code book for complete descriptions of these codes.

Provider Manual(s) Page(s) Updated
Audiology speech cd (2, 3)
Chronic Dialysis Clinics immun (5, 9, 12, 17–23); immun cd (1, 3); inject cd list (1, 3–5, 10, 11, 16, 21, 24); inject drug a-d (29); inject drug e-h (55–57); inject drug i-m (7, 23, 24, 34, 35); inject drug s-z (26–29); modif used (11–14); non ph (10, 13–15, 30)
Clinics and Hospitals
General Medicine
chemo drug a-d (13, 22–24); chemo drug p-z (27, 28); immun (5, 9, 12, 17–23); immun cd (1, 3); inject cd list (1, 3–5, 10, 11, 16, 21, 24); inject drug a-d (29); inject drug e-h (55–57); inject drug i-m (7, 23, 24, 34, 35); inject drug s-z (26–29); medne tele (10, 12); modif used (11–14); non ph (10, 13–15, 30); presum bill (19); prop lab (1, 22, 57–59); radi dia (22); radi nuc (7); surg urin (5); tar and non cd0 (32)
Community-Based Adult Services
Therapies
occu cd (1); once (1–3); phys cd (3); speech cd (2, 3)
Inpatient Services tar and non cd0 (32)
Obstetrics immun (5, 9, 12, 17–23); immun cd (1, 3); inject cd list (1, 3–5, 10, 11, 16, 21, 24); inject drug a-d (29); inject drug e-h (55–57); inject drug i-m (7, 23, 24, 34, 35); inject drug s-z (26–29); modif used (11–14); non ph (10, 13–15, 30); presum bill (19); prop lab (1, 22, 57–59); radi dia (22); radi nuc (7); surg urin (5); tar and non cd0 (32)
Pharmacy immun (5, 9, 12, 17–23); immun cd (1, 3); inject cd list (1, 3–5, 10, 11, 16, 21, 24); inject drug a-d (29); inject drug e-h (55–57); inject drug i-m (7, 23, 24, 34, 35); inject drug s-z (26–29); presum bill (19)
Rehabilitation Clinics immun (5, 9, 12, 17–23); immun cd (1, 3); inject cd list (1, 3–5, 10, 11, 16, 21, 24); inject drug a-d (29); inject drug e-h (55–57); inject drug i-m (7, 23, 24, 34, 35); inject drug s-z (26–29); modif used (11–14); non ph (10, 13–15, 30); occu cd (1); once (1–3); phys cd (3); speech cd (2, 3)

6. New Vaccines for Children (VFC) Benefit

Effective for dates of service on or after May 1, 2021, CPT® code 90697 (diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine [DTaP-IPV-Hib-HepB], for intramuscular use) is a Medi-Cal and Vaccines For Children (VFC) benefit.

Modifier SL is required when administering the vaccine supplied by the VFC program. Modifiers SA, SB, UD, U7 and 99 are allowed. Recipients must be between 6 weeks and 4 years of age (prior to the 5th birthday).

7. Update: Adverse Childhood Experiences (ACE) Screening Policy

Medi-Cal’s Adverse Childhood Experiences (ACE) screening policy, effective January 1, 2020, can be found in the Evaluation & Management (E&M) section of the provider manual and on the ACEs Aware website at: acesaware.org.

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
General Medicine
Obstetrics
Psychological Services
eval (10, 28); prev (16); psychol (7)

8. Erroneously Denied Claims for Maternal Depression Screening

Due to a system error, beginning July 1, 2020, some claims for maternal depression screening using HCPCS codes G8431 (screening for depression is documented as being positive and a follow-up plan is documented) and G8510 (screening for depression is documented as negative, a follow-up plan is not required) were denied when the claim used the infant’s Medi-Cal ID.

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

9. Hereditary Retinal Disorders is a Medi-Cal Benefit

Effective for dates of service on or after May 1, 2021, the Department of Health Care Services (DHCS) has updated CPT® code 81434 (hereditary retinal disorders [e.g., retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy], genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4, CNGA1, CRB1, EYS, PDE6A, PDE6B, PRPF31, PRPH2, RDH12, RHO, RP1, RP2, RPE65, RPGR and USH2A) from being a non-benefit to a benefit.

A Treatment Authorization Request (TAR) for code 81434 requires documentation of the following criteria:

  • Patient has a clinical diagnosis of retinal dystrophy (retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy) and

  • The decision for gene therapy is contingent on the test results

CPT code 81434 has a frequency limit of once in a lifetime and the allowable modifiers are 33, 90 and 99. The age and gender coverage are retained.

Provider Manual(s) Page(s) Updated
Chronic Dialysis Clinics modif used (4)
Clinics and Hospitals
General Medicine
Obstetrics
modif used (4); non ph (9); once (9); path molec (76); tar and non cd8 (10)
Long-Term Care tar and non cd8 (10)
Rehabilitation Clinics modif used (4)

10. PLA Code Billing Reminders

A previously-published Medi-Cal Update article titled “Proprietary Laboratory Analyses (PLA) Codes Implementation Complete” announced that PLA codes are now ready to be processed by Medi-Cal.

The Department of Health Care Services (DHCS) wishes to remind providers of the following information when they are submitting claims with PLA codes:

  • If billing with modifiers, only modifiers 33, 90 or 99 may be submitted on the claim. DHCS will update the applicable modifiers and billing instructions to existing PLA codes as needed based on applicable federal and state requirements.

  • PLA codes are not split-billable.

  • Providers should consult whether or not the PLA code is “By Report,” and provide the proper “By Report” documentation when required.

If submitted without appropriate modifiers, or “By Report” documentation, providers may receive the following RAD code denials for PLA claims. Providers who experience denials for these reasons should readjust and resubmit their claims.

  • RAD Code 090: The combination of procedure code and modifier is not valid on the dates of service billed.

  • RAD Code 188: This is a “By Report” procedure. No report is attached or the attached report is insufficient to warrant payment.
Provider Manual(s) Page(s) Updated
Chronic Dialysis Clinics
Clinics and Hospitals
General Medicine
Obstetrics
path bil (2, 3); tar and non cd0 (2)
Inpatient Services tar and non cd0 (2)

11. 2021 Income Eligibility Guidelines for the CHDP Gateway Program

Effective January 1, 2021, through December 31, 2021, providers are to use the following income guidelines when determining recipient eligibility for pre-enrollment in Medi-Cal through the Child Health and Disability Prevention (CHDP) Gateway program. Providers should disregard all previous CHDP income eligibility guidelines charts.

Income Eligibility Guidelines
266 Percent of the 2021 Federal Poverty Guidelines
Effective January 1, 2021, through December 31, 2021
(For determinations of CHDP Gateway aid codes 8W and 8X only)
Number of Persons in the Household Monthly Income Annual Income
1 $2,856 $34,261
2 $3,862 $46,338
3 $4,868 $58,414
4 $5,875 $70,490
5 $6,881 $82,567
6 $7,887 $94,643
7 $8,894 $106,720
8 $9,900 $118,796
9 $10,906 $130,872
10 $11,913 $142,949
For households of more than 10 persons,
for each additional person, add:
$1,007 $12,077
Provider Manual(s) Page(s) Updated
Audiology and Hearing Aids
Clinics and Hospitals
General Medicine
Obstetrics
Orthotics and Prosthetics
Psychological Services
Vision Care
epsdt chdp gate (11)

12. 2021 Income Eligibility Guidelines for PE4PW

Effective January 1, 2021 through December 31, 2021, Presumptive Eligibility for Pregnant Women (PE4PW) program providers must use the following income guidelines to make PE4PW eligibility determinations. Providers should disregard all previous PE4PW income eligibility guidelines charts.

Federal Poverty Level Chart for PE4PW
Effective January 1, 2021, through December 31, 2021

Number of Persons in Family Monthly Gross Family Income
(in dollars)
Annual Gross Family Income
(in dollars)
2 3,093 37,105
3 3,898 46,775
4 4,704 56,445
5 5,510 66,116
6 6,316 75,786
7 7,122 85,456
8 7,928 95,126
9 8,733 104,796
10 9,539 114,467
11 10,345 124,137
12 11,151 133,807
For family units of more than 12 members,
for each additional member, add:
806 9,671

 

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
General Medicine
Obstetrics
Pharmacy
presum (4)

13. Every Woman Counts 2021 Income Eligibility Guidelines

Effective April 1, 2021, through March 31, 2022, Every Woman Counts (EWC) providers are to use the following income guidelines when determining recipient eligibility for EWC. Providers should disregard all previous income eligibility guideline charts.

EWC recipients must have a household income at or below 200 percent of the federal Health and Human Services (HHS) poverty guidelines. The HHS poverty guidelines are adjusted annually. “Gross household income” means income before taxes and other deductions.

EWC Income Eligibility Guidelines
200 Percent of the 2021 HHS Poverty Guidelines by Household Size
Effective April 1, 2021, through March 31, 2022
Number of Persons Living in Household Monthly Gross Household Income (in dollars) Annual Gross Household Income (in dollars)
1 2,147 25,760
2 2,903 34,840
3 3,660 43,920
4 4,417 53,00
5 5,173 62,080
6 5,930 71,160
7 6,687 80,240
8 7,443 89,320
For each additional person, add: 757 9,080

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
General Medicine
Obstetrics
ev woman (10)

14. Updates to Billing Instructions for Contraceptive Vaginal Rings

Effective for dates of service on or after November 1, 2020, segesterone acetate and ethinyl estradiol vaginal system (Annovera®) is added as a benefit under Family Planning, Access, Care and Treatment (Family PACT) and Medi-Cal programs for clinic dispensing, and for Family PACT pharmacy dispensing.

For clinic dispensing, HCPCS code J7303 (contraceptive supply, hormone containing vaginal ring, each) must be billed with modifier U1 for etonogestrel and ethinyl estradiol (NuvaRing®) or U2 for segesterone acetate and ethinyl estradiol vaginal system (Annovera).

HCPCS code J7303U1 is restricted to a dispensing quantity of up to 13 rings, per client, with a maximum of two dispensings in a 12-month period. HCPCS code J7303U2 is restricted to one ring per dispensing, per client, with a maximum of two dispensings in a 12-month period. For both codes, a Treatment Authorization Request (TAR) is required for a third dispensing of the same product requested within a 12-month period.

Pharmacy dispensing of segesterone acetate and ethinyl estradiol vaginal system (Annovera) has the same restrictions as noted for J7303U2.

Provider Manual(s) Page(s) Updated
AIDS Waiver Program
Audiology and Hearing Aids
Chronic Dialysis Clinics
Durable Medical Equipment
Home Health Agencies/Home and Community-Based Services
Local Educational Agency
Medical Transportation
Orthotics and Prosthetics
Therapies
Vision Care
modif app (22, 23)
Clinics and Hospitals
General Medicine
Obstetrics
fam planning (5, 9); non ph (12, 24); modif app (22, 23)
Family PACT ben fam (12); ben grid (3, 45); clinic (20); drug (3, 6, 7); pharmacy (14)
Rehabilitation Clinics non ph (12, 24); modif app (22, 23)

15. TAR Required for Laparoscopy Billing

Effective retroactively for dates of service on or after October 1, 2017, CPT® code 58661 (laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]), requires an approved Treatment Authorization Request (TAR) form for reimbursement under the Medi-Cal program.

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

16. Frequency Limit Updated for HCPCS Codes G0480 thru G0483 and G0659

Effective retroactively for dates of service on or after March 1, 2019, the frequency limit is updated from once per week to once per day, any provider, with Treatment Authorization Request (TAR)/Service Authorization Request (SAR) override for the following HCPCS codes:

HCPCS Code Description
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to, GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays [e.g., IA, EIA, ELISA, EMIT, FPIA] and enzymatic methods [e.g., alcohol dehydrogenase]), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1–7 drug class(es), including metabolite(s) if performed
G0481 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to, GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays [e.g., IA, EIA, ELISA, EMIT, FPIA] and enzymatic methods [e.g., alcohol dehydrogenase]), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8–14 drug class(es), including metabolite(s) if performed
G0482 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to, GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays [e.g., IA, EIA, ELISA, EMIT, FPIA] and enzymatic methods [e.g., alcohol dehydrogenase]), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15–21 drug class(es), including metabolite(s) if performed
G0483 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to, GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays [e.g., IA, EIA, ELISA, EMIT, FPIA] and enzymatic methods [e.g., alcohol dehydrogenase]), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed
G0659 Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to, GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem), excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes

An Erroneous Payment Correction (EPC) will be processed for affected claims. No action is required on the part of providers.

17. 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 April 1, 2021
NDC Labeler Code Contracting Company's Name
24689 Apnar Pharma
60219 Amneal Pharmaceuticals
70512 Sola Pharmaceuticals
71127 Laboratoire Francais Du Fractionnement
71247 Innogenix, LLC
71308 Trevena, Inc.
71837 Partner Therapeutics, Inc.
72078 Mylan Institutional LLC
72089 Evoke Pharma Inc.
72516 Oryza Pharmaceuticals, Inc.
72570 Delsam Pharma LLC
72763 Estreno Pharmaceuticals LLC
72829 Rhythm Pharmaceuticals, Inc.
72974 Myovant Sciences, Inc.
73042 Y-MAbs Therapeutics, Inc.
73079 Eiger Biopharmaceuticals Inc.
73090 Eusa Pharma (US) LLC
73150 TG Therapeutics, Inc.
74676 Verity Pharmaceuticals Inc.
75626 Aurinia Pharma U.S, Inc.
78670 USWM, LLC
Terminations, effective April 1, 2021
NDC Labeler Code Contracting Company's Name
16103 Pharbest Pharmaceuticals, Inc.
24987 Covis Pharmaceuticals Inc.
28105 Hill Dermaceuticals, Inc.
49663 Raptor Therapeutics, Inc.
50484 Smith & Nephew, Inc.
57881 Galena Biopharma, Inc.
64116 Intermune Pharmaceuticals, Inc.
65847 Scios Inc.
68712 JSJ Pharmaceuticals
70868 Key Therapeutics, LLC
72245 Forte Bio-Pharma LLC
72508 Neopharma 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 (6, 7, 9, 11, 12, 14–16, 18–22)

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19. Provider Manual Revisions



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