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Medi-Cal Update

Psychological Services | April 2022 | Bulletin 559

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1. 2022 HCPCS Quarter 2 Update

The 2022 quarter 2 updates to the Healthcare Common Procedure Coding System (HCPCS) codes are available in the HCPCS Policy Updates PDF. The code additions, changes and deletions are effective for dates of service on or after April 1, 2022 (unless otherwise specified).
Only those codes representing current and past Medi-Cal benefits are included in the list of updates. Please refer to the HCPCS Level I and II code books for complete descriptions of these codes.

Provider Manual(s) Page(s) Updated
AIDS Waiver Program modif app (2, 3, 11, 12)
Audiology and Hearing Aids blood (14–16); immun (50–63, 60–62); immun cd (1, 3, 4); inject cd list (2, 3, 6, 7, 16, 21, 22, 23, 25, 26); inject drug a-d (12, 13, 20, 77–80); inject drug n-r (30, 31, 34, 36–41); inject drug s-z (18); modif app (2, 3, 11, 12); modif used (14, 15)
Clinics and Hospitals
General Medicine
blood (14–16); chemo drug a-d (37); chemo drug e-o (30); chemo drug p-z (30–32, 41); immun (50–63, 60–62); immun cd (1, 3, 4); inject cd list (2, 3, 6, 7, 16, 21, 22, 23, 25, 26); inject drug a-d (12, 13, 20, 77–80); inject drug n-r (30, 31, 34, 36–41); inject drug s-z (18); modif app (2, 12); modif used (14,15); non ph (10, 14, 15, 17, 29, 30, 32); ophthal (8, 9, 23, 24, 30–32); presum bill (3, 13, 16–18, 21); prop lab (21, 24, 62–64); radi dia (22, 23); surg cardio (7); surg integ (4, 6); surg muscu (2, 3); tar and noncd0 (41, 42)
Durable Medical Equipment dura cd fre (6, 11); dura other (16–18, 23); modif app (2, 3, 11, 12); tax (23, 44)
Home Health Agencies/Home and Community-Based Services
Local Educational Agency
Medical Transportation
Vision Care
modif app (2, 3, 11, 12)
Inpatient Services tar and noncd0 (41, 42)
Obstetrics immun (50–63, 60–62); immun cd (1, 3, 4); inject cd list (2, 3, 6, 7, 16, 21, 22, 23, 25, 26); inject drug a-d (12, 13, 20, 77–80); inject drug n-r (30, 31, 34, 36–41); inject drug s-z (18); modif app (2, 3, 11, 12); modif used (14, 15); non ph (10, 14, 15, 17, 29, 30, 32); presum bill (3, 13, 16–18, 21); prop lab (21, 24, 62–64); radi dia (22, 23); tar and noncd0 (41, 42)
Orthotics and Prosthetics dura cd fre (6, 11); modif app (2, 3, 11, 12); tax (23, 44)
Pharmacy dura cd fre (6, 11); dura other (16–18, 23); immun (50–63, 60–62); immun cd (1 ,3 ,4); inject cd list (2, 3, 6, 7, 16, 21, 22, 23, 25, 26); inject drug a-d (12, 13, 20, 77–80); inject drug n-r (30, 31, 34, 36–41); inject drug s-z (18); presum bill (3, 13, 16–18, 21); tax (23, 44)
Rehabilitation Clinics immun (50–63, 60–62); immun cd (1, 3, 4); inject cd list (2, 3, 6, 7, 16, 21, 22, 23, 25, 26); inject drug a-d (12, 13, 20, 77–80); inject drug n-r (30, 31, 34, 36–41); inject drug s-z (18); modif app (2, 3, 11, 12); modif used (14,15); non ph (10,14, 15, 17, 29, 30, 32)
Therapies dura cd fre (6, 11); modif app (2, 3, 11, 12)

2. Child Health and Disability Prevention Program and Expanding Children's Presumptive Eligibility

On February 25, 2022, the Department of Health Care Services (DHCS) published a new Child Health and Disability Prevention (CHDP) Program Letter 22-02 and CHDP Provider Notice 22-02 notifying CHDP programs and CHDP providers statewide of the DHCS Proposal to Discontinue the CHDP Program by July 1, 2023 in order to simplify and streamline the delivery of services to children and youth under the age of 21, in alignment with the goals of the California Advancing and Innovating Medi-Cal (CalAIM) initiative.

For more information providers can visit the CHDP Program Letters and Provider Information Notices website, or review the letter and notice in the links below:

Further announcements regarding this transition will be released as they become available in the coming months.

Providers can visit the DHCS CHDP Program website for CHDP program related information.

3. Older Adult Expansion into Full Scope Medi-Cal

Beginning May 1, 2022, a new law in California will provide adults 50 years of age or older access to full scope Medi-Cal services and immigration status does not matter. All other Medi-Cal eligibility rules, including income limits, will still apply. This initiative, called the Older Adult Expansion, is modeled after Senate Bill 75 and the Young Adult Expansion, which provided full scope Medi-Cal to all eligible children and young adults under the age of 26 regardless of immigration status.

To support the implementation of this initiative, DHCS has created a dedicated Older Adult Expansion web page. The web page currently hosts the following type of information, but the resources on this page will continue to grow as the Older Adult Expansion evolves:

  • A PowerPoint presentation sharing the roadmap to the Older Adult Expansion to Medi-Cal stakeholders,

  • Frequently Asked Questions (FAQ), and

  • First notice, General Information Notice, to Beneficiaries regarding their expansion of benefits.

Providers finding themselves working with beneficiaries who ask about the Older Adult Expansion may leverage these resources for educational purposes.

County offices or other Medi-Cal stakeholders seeking specific policy guidance regarding the Older Adult Expansion may find more information posted in ACWDL 21-13, located on the DHCS website in the All County Welfare Directors’ Letters (ACWDL) page.

Additionally, county offices seeking global outreach language to promote this expansion, may find preliminary messaging in MEDIL 22-02, on the Medi-Cal Eligibility Division Information Letter (MEDIL) web page. The global outreach language currently available includes messaging that can be used in various forms of outreach including social media posts, call scripts, and county website content.

For all other questions related to the Older Adult Expansion, please feel free to contact DHCS at OlderAdultExpansion@dhcs.ca.gov.

4. Update to Provider Manual Terminology to Remove “Alien”

In accordance with Assembly Bill 1096 (Luz Rivas, Chapter 296, Status of 2021), the Medi-Cal Provider Manual is updated to replace the word “alien” with language more reflective of the present legal terminology, such as “non-citizen.”

Provider Manual(s) Page(s) Updated
AIDS Waiver Program
Chronic Dialysis Clinics
Clinics and Hospitals
Heroin Detoxification
Home Health Agencies/Home and
Community-Based Services
Hospice Care Program
Rehabilitation Clinics
medi cr op (23, 26)
Audiology
Chiropractic
Durable Medical Equipment
General Medicine
Medical Transportation
Obstetrics
Orthotics and Prosthetics
Pharmacy
Psychological Services
Therapies
medi cr cms (18, 20)
Inpatient Services medi cr ip (17, 19)
Long Term Care medi cr ltc (8, 12)
Vision Care medi cr vc (13)

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