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Medi-Cal Update

Hospice Care Program | April 2021 | Bulletin 559

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1. 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.

2. 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)

3. 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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5. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:



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