Provisional Postpartum Care Extension
July 31, 2020
Effective for dates of service on or after August 1, 2020, the Department of Health Care Services (DHCS) will implement the Provisional Postpartum Care Extension (PPCE) program.
Currently, a pregnant individual, who was eligible for and received Medi-Cal or Medi-Cal Access Program (MCAP) during the last month of pregnancy, shall continue to be eligible for a 60-day period beginning on the last day of pregnancy. Eligibility ends on the last day of the month in which the 60th day occurs.
Under PPCE, if a Medi-Cal or MCAP eligible individual is diagnosed with a maternal mental health condition (including, but not limited to, postpartum depression) during their pregnancy, postpartum period, or within 90 days from the end of the postpartum period, the individual may remain eligible in their current Medi-Cal or MCAP eligibility category for up to one year following the last day of the individual’s pregnancy.
To qualify for PPCE, verification of a maternal mental health diagnosis in the form of the Medical Report for Medi-Cal or MCAP Postpartum Care Extension (MC 61) must be received by the MCAP or Medi-Cal program. The completed MC 61, signed by the treating health care provider, must be received by the Medi-Cal or MCAP program before the end of the 90-day period following the postpartum period, unless good cause is established. This verification (MC 61) will provide the individual with an additional ten months of coverage, including all mental health services and benefits covered by MCAP or Medi-Cal for adults. The MC 61 will be posted to the Forms webpage on the DHCS website when available.
The PPCE program may be suspended on December 31, 2021, unless further legislative action is taken. Should the suspension occur, the Legislature intends to consider alternative solutions to restore this program.
Additional information about PPCE is available on the new Provisional Postpartum Care Extension (PPCE) web page. Questions concerning PPCE should be sent to Pregnancy@dhcs.ca.gov.