Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Part 2 – Community–Based Adult Services (formerly Adult Day Health Care Centers)

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Medi-Cal Program (00medi-cal)

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Medi-Cal Provider Manual Contents

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Manual Organization (0Amanorg)

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How to Use This Manual (0Bhwtouse)

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Getting Started: Where to Find the Answers (0C get start)

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Contents (Part 2 – Medi-Cal Billing and Policy): Adult Day Health Care (ADHC) Centers (ADU) (2toc adu)

112,485 Bytes166,400 Bytes

Appeal Form Completion (appeal form)

19,875 Bytes74,240 Bytes

Audiological Services (audio)

9,459 Bytes32,256 Bytes

Audiological Services: Billing Codes and Reimbursement Rates (audio cd)

57,829 Bytes95,744 Bytes

Audiological Services Billing Example: UB-04 (audio exu)

126,123 Bytes209,920 Bytes

CIF Completion (cif co)

116,392 Bytes173,568 Bytes

CIF Special Billing Instructions for Outpatient Services (cif sp op)

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CIF Submission and Timeliness Instructions (cif sub)

30,636 Bytes129,536 Bytes

Community-Based Adult Services (CBAS) (community)

11,795 Bytes42,496 Bytes

Community-Based Adult Services (CBAS): Billing Codes and Reimbursement Rates (community cd)

71,300 Bytes111,104 Bytes

Community-Based Adult Services (CBAS) Billing Examples (community ex)

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Community-Based Adult Services (CBAS): IPC and TAR Form Completion (community ipc)

17,580 Bytes69,632 Bytes

Correct Coding Initiative: National (correct)

133,281 Bytes173,568 Bytes

Correct Coding Initiative: National – Claim Preparation (correct cod)

52,562 Bytes622,592 Bytes

Drugs: Contract Drugs List Part 5 – Authorized Manufacturer Labeler Codes (drugs cdl p5)

13,843 Bytes43,520 Bytes

Forms: Legibility and Completion Standards (forms leg)

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Forms Reorder Request: Guidelines (forms reo)

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Forms Reorder Request: Inpatient and Outpatient Services (forms reo io)

11,009 Bytes36,352 Bytes

HCPCS Introduction (hcpcs)

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HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes (hcpcs iii)

18,503 Bytes65,024 Bytes

Indian Health Services (IHS), Memorandum of Agreement (MOA) 638, Clinics (ind health)

20,437 Bytes104,448 Bytes

Indian Health Services (IHS), Memorandum of Agreement (MOA) 638, Clinics: Billing Codes (ind health cd)

13,995 Bytes49,152 Bytes

Occupational Therapy (occu)

5,756 Bytes33,792 Bytes

Occupational Therapy: Billing Codes and Reimbursement Rates (occu cd)

49,293 Bytes82,432 Bytes

Occupational Therapy Billing Example: UB-04 (occu exu)

33,168 Bytes132,608 Bytes

Optional Benefits Exclusion (opt ben exc)

16,266 Bytes54,784 Bytes

Other Health Coverage (OHC) (oth hlth)

12,701 Bytes49,152 Bytes

Other Health Coverage (OHC): CPT-4 and HCPCS Codes (oth hlth cpt)

10,372 Bytes35,840 Bytes

Physical Therapy (phys)

6,223 Bytes32,256 Bytes

Physical Therapy: Billing Codes and Reimbursement Rates (phys cd)

60,752 Bytes97,280 Bytes

Physical Therapy Billing Example: UB-04 (phys exu)

15,656 Bytes54,272 Bytes

Physician-Administered Drugs: NDC (physician ndc)

18,357 Bytes58,880 Bytes

Physician-Administered Drugs – NDC: UB-04 Billing Instructions (physician ndc ub)

12,367 Bytes44,032 Bytes

Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry) (prov bil)

12,139 Bytes40,448 Bytes

Remittance Advice Details (RAD) (remit adv)

28,367 Bytes174,592 Bytes

Remittance Advice Details (RAD) Examples: Outpatient Services (remit ex op)

10,686 Bytes35,328 Bytes

Remittance Advice Details (RAD): Payments and Claim Status (remit pay)

22,390 Bytes75,264 Bytes

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) (rural)

24,490 Bytes111,616 Bytes

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): Billing Codes (rural cd)

47,373 Bytes80,896 Bytes

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Billing Examples (rural ex)

109,943 Bytes166,400 Bytes

Share of Cost (SOC): UB-04 for Outpatient Services (share op)

12,148 Bytes44,544 Bytes

Sign Language Interpretation (sign)

17,263 Bytes67,584 Bytes

Speech Generating Devices (SGD) (spe dev)

14,106 Bytes48,128 Bytes

Speech Therapy (speech)

11,094 Bytes48,128 Bytes

Speech Therapy: Billing Codes and Reimbursement Rates (speech cd)

57,050 Bytes97,280 Bytes

Speech Therapy Billing Example: UB-04 (speech exu)

77,141 Bytes138,240 Bytes

TAR Completion (tar comp)

294,934 Bytes543,232 Bytes

TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer)

29,977 Bytes124,416 Bytes

TAR Field Office Addresses (tar field)

104,194 Bytes151,552 Bytes

TAR Submission: Transmittal Form (tar submis)

10,532 Bytes33,792 Bytes

TAR: Submitting Appeals (tar submit)

369,974 Bytes562,176 Bytes

UB-04 Completion: Outpatient Services (ub comp op)

25,187 Bytes62,976 Bytes

UB-04 Special Billing Instructions for Outpatient Services (ub spec op)

21,512 Bytes88,576 Bytes

UB-04 Submission and Timeliness Instructions (ub sub)

14,952 Bytes58,368 Bytes

UB-04 Tips for Billing: Outpatient Services (ub tips op)



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