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Medi-Cal Update

Therapies | April 2021 | Bulletin 547

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1. 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)

2. 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.

3. 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)

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5. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:



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