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Provider Manuals
Part 2 - Durable Medical Equipment and Medical Supplies (DME)
Medi-Cal Program (00medi-cal)
(Revision Date Apr 16, 2021) |
95KB)
How to Use This Manual (0B hw to use)
(Revision Date Feb 16, 2022) |
392KB)
Getting Started: Where to Find the Answers (0C get start)
(Revision Date Jan 14, 2022) |
269KB)
Appeal Form Completion (appeal form)
(Revision Date May 16, 2022) |
632KB)
California Children’s Services (CCS) Program (cal child)
(Revision Date Dec 31, 2021) |
166KB)
California Children’s Services (CCS) Program Approved Hospitals (cal child appr)
(Revision Date Aug 14, 2020) |
111KB)
California Children’s Services (CCS) Program Billing (cal child bil)
(Revision Date Jun 16, 2022) |
140KB)
California Children’s Services (CCS) Program Billing Example: CMS-1500 (cal child bil cms)
(Revision Date Jun 16, 2022) |
602KB)
CCS Program Billing Guidelines (cal child bil guide)
(Revision Date Jun 16, 2022) |
77KB)
California Children’s Services (CCS) Program County Office Directory (cal child county)
(Revision Date Oct 15, 2021) |
182KB)
California Children’s Services (CCS) Program Eligibility (cal child elig)
(Revision Date Jun 16, 2022) |
170KB)
California Children’s Services (CCS) Program Medical Therapy Program (cal child med)
(Revision Date Nov 30, 2021) |
158KB)
California Children’s Services (CCS) Program Provider Paneling (cal child panel)
(Revision Date Nov 30, 2021) |
207KB)
Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Physicians and Podiatrists (DHS 4514)
(Revision Date May 29, 2020) |
44KB)
Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Allied Health Care Professionals (DHS 4515 )
(Revision Date May 29, 2020) |
69KB)
California Children’s Services (CCS) Program Referrals (cal child ref)
(Revision Date Jun 16, 2022) |
147KB)
California Children’s Services (CCS) Program Service Authorization Request (SAR) (cal child sar)
(Revision Date Apr 29, 2022) |
227KB)
California Children’s Services (CCS) Program Service Code Groupings (cal child ser)
(Revision Date Jan 31, 2022) |
498KB)
California Children’s Services (CCS) Program Special Care Centers (cal child spec)
(Revision Date Sep 16, 2020) |
91KB)
CIF Completion (cif co)
(Revision Date May 16, 2022) |
710KB)
CIF Special Billing Instructions (cif sp)
(Revision Date Dec 31, 2021) |
623KB)
CIF Submission and Timeliness Instructions (cif sub)
(Revision Date Oct 16, 2020) |
177KB)
CMS-1500 Completion (cms comp)
(Revision Date May 16, 2022) |
843KB)
CMS-1500 Special Billing Instructions (cms spec)
(Revision Date Oct 16, 2020) |
212KB)
CMS-1500 Submission and Timeliness Instructions (cms sub)
(Revision Date Feb 16, 2022) |
126KB)
CMS-1500 Tips for Billing (cms tips)
(Revision Date Oct 16, 2020) |
165KB)
Correct Coding Initiative: National (correct)
(Revision Date Jun 16, 2022) |
159KB)
Correct Coding Initiative: National – Claim Preparation (correct cod)
(Revision Date May 16, 2022) |
241KB)
Durable Medical Equipment (DME): An Overview
(Revision Date Jun 16, 2022) |
150KB)
Form: Certificate of Medical Necessity for All Durable Medical Equipment (DME) (Except Wheelchairs and Scooters) (DHS 6181)
(Revision Date May 29, 2020) |
127KB)
Form: Certificate of Medical Necessity for Apnea Monitors (MC 4600)
(Revision Date May 29, 2020) |
29KB)
Form: Certificate of Medical Necessity for Nebulizers (MC 4601)
(Revision Date May 29, 2020) |
27KB)
Form: Certificate of Medical Necessity for Oxygen (MC 4602)
(Revision Date May 29, 2020) |
63KB)
Durable Medical Equipment (DME): Bill for DME (dura bil)
(Revision Date Oct 15, 2020) |
212KB)
Durable Medical Equipment (DME): Bill for Wheelchairs and Wheelchair Accessories (dura bil wheel)
(Revision Date Jul 16, 2021) |
203KB)
Form: Certificate of Medical Necessity for a Manual Wheelchair, Standard or Custom (DHS 6181-A)
(Revision Date May 29, 2020) |
474KB)
Form: Certificate of Medical Necessity for a Motorized Wheelchair, Custom or Standard (DHS 6181-B)
(Revision Date May 29, 2020) |
447KB)
Form: Certificate of Medical Necessity for a Power Operated Vehicle (POV) aka Scooter, Standard or Bariatric (DHS 6181-C)
(Revision Date May 29, 2020) |
390KB)
Durable Medical Equipment (DME): Billing Codes and Reimbursement Rates (dura cd)
(Revision Date Nov 16, 2021) |
865KB)
Durable Medical Equipment (DME): Billing Codes for California Children’s Services (CCS) (dura cd ccs)
(Revision Date Nov 30, 2021) |
116KB)
Durable Medical Equipment (DME) Billing Codes: Frequency Limits (dura cd fre)
(Revision Date Apr 15, 2022) |
277KB)
Durable Medical Equipment (DME): Billing Examples (dura ex)
(Revision Date Sep 16, 2020) |
4011KB)
Durable Medical Equipment (DME): Infusion Equipment (dura inf)
(Revision Date Nov 16, 2021) |
136KB)
Durable Medical Equipment (DME): Other DME Equipment (dura other)
(Revision Date Apr 15, 2022) |
333KB)
Durable Medical Equipment (DME): Oxygen and Respiratory Equipment (dura oxy)
(Revision Date Apr 15, 2022) |
449KB)
Durable Medical Equipment (DME): Speech Generating Devices (SGD) (dura spe)
(Revision Date Jul 16, 2021) |
134KB)
Durable Medical Equipment (DME): Therapeutic Anti-Decubitus Mattresses and Bed Products (dura thp)
(Revision Date Jul 16, 2021) |
374KB)
Durable Medical Equipment (DME): Wheelchair and Wheelchair Accessories Guidelines (dura wheel guide)
(Revision Date Jul 16, 2021) |
273KB)
Enteral Nutrition Products (enteral)
(Revision Date Apr 29, 2022) |
89KB)
Forms: Legibility and Completion Standards (forms leg)
(Revision Date Oct 16, 2020) |
129KB)
Forms Reorder Request: Guidelines (forms reo)
(Revision Date Dec 31, 2021) |
107KB)
Forms Reorder Request: Medical Services and Allied Health (forms reo ma)
(Revision Date Sep 16, 2020) |
375KB)
Genetically Handicapped Persons Program (GHPP) (genetic)
(Revision Date Dec 31, 2021) |
246KB)
HCPCS Introduction (hcpcs)
(Revision Date Aug 14, 2020) |
114KB)
HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes (hcpcs iii)
(Revision Date Aug 31, 2020) |
143KB)
Incontinence Medical Supplies (incont)
(Revision Date Apr 29, 2022) |
229KB)
Incontinence Medical Supplies Example: CMS-1500 (incont ex)
(Revision Date Apr 29, 2022) |
501KB)
Intravenous or Intra-arterial Solutions: Administration Sets (iv sol admin)
(Revision Date Aug 31, 2020) |
108KB)
Medical Supplies (mc sup)
(Revision Date Apr 29, 2022) |
245KB)
Medical Supplies: Billing Examples (mc sup ex)
(Revision Date Jul 30, 2021) |
719KB)
Medicare/Medi-Cal Crossover Claims: CMS-1500 (medi cr cms)
(Revision Date Apr 15, 2022) |
267KB)
Medicare/Medi-Cal Crossover Claims: CMS-1500 Billing Examples for Allied Health (medi cr cms exa)
(Revision Date Aug 31, 2020) |
360KB)
Medicare/Medi-Cal Crossover Claims: CMS-1500 Pricing Examples for Allied Health (medi cr cms pra)
(Revision Date Aug 31, 2020) |
591KB)
Medicare/Medi-Cal Crossover Claims: UB-04 (medi cr ub)
(Revision Date Sep 16, 2020) |
186KB)
Medicare/Medi-Cal Crossover Claims: UB-04 Billing Examples (medi cr ub ex)
(Revision Date Aug 31, 2020) |
1330KB)
Medicare Non-Covered Services: Charts Introduction (medi non cha)
(Revision Date May 14, 2021) |
107KB)
Medicare Non-Covered Services: HCPCS Codes (medi non hcp)
(Revision Date Jun 16, 2022) |
129KB)
Modifiers: Approved List (modif app)
(Revision Date Jun 16, 2022) |
339KB)
Orthotic and Prosthetic Appliances: Billing Codes and Reimbursement Rates – Orthotics (ortho cd1)
(Revision Date Aug 14, 2020) |
486KB)
Orthotic and Prosthetic Appliances: Billing Codes and Reimbursement Rates – Prosthetics (ortho cd2)
(Revision Date Feb 16, 2022) |
367KB)
Orthotics and Prosthetics: Frequency Limits for Orthotics (ortho cd fre1)
(Revision Date Aug 31, 2020) |
265KB)
Orthotics and Prosthetics: Frequency Limits for Prosthetics (ortho cd fre2)
(Revision Date May 16, 2022) |
243KB)
Other Health Coverage (OHC) (oth hlth)
(Revision Date Dec 31, 2021) |
93KB)
Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry) (prov bil)
(Revision Date Dec 31, 2021) |
127KB)
Remittance Advice Details (RAD) (remit adv)
(Revision Date May 16, 2022) |
131KB)
Remittance Advice Details (RAD) Examples: Allied Health, Medical Services and Pharmacy (remit ex amp)
(Revision Date Jan 14, 2022) |
294KB)
Remittance Advice Details (RAD): Payments and Claim Status (remit pay)
(Revision Date May 16, 2022) |
75KB)
Respiratory Care (respir)
(Revision Date Dec 16, 2021) |
190KB)
Share of Cost (SOC): CMS-1500 (share cms)
(Revision Date Dec 31, 2021) |
823KB)
Sign Language Interpretation (sign)
(Revision Date Aug 31, 2020) |
136KB)
TAR Completion (tar comp)
(Revision Date Jun 16, 2022) |
398KB)
TAR Criteria for NF Authorization (Valdivia v. Coye) (tar crit nf)
(Revision Date Dec 16, 2021) |
187KB)
TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer)
(Revision Date Dec 31, 2021) |
1563KB)
TAR Field Office Addresses (tar field)
(Revision Date Dec 31, 2021) |
357KB)
TAR Submission: Transmittal Form (tar submis)
(Revision Date Aug 31, 2020) |
220KB)
TAR: Submitting Appeals (tar submit)
(Revision Date Sep 28, 2020) |
114KB)
Taxable and Non-Taxable Items (tax)
(Revision Date Apr 15, 2022) |
692KB)
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