Erroneously Denied Family PACT Claims for HCPCS Code T1014 with RAD Code 9516

August 28, 2020

The Department of Health Care Services (DHCS) has identified a claims processing issue that causes Family PACT claims billed for HCPCS Code T1014 (telehealth transmission, per minute, professional services bill separately) to be denied with Remittance Advice Details (RAD) Code 9516: The secondary diagnosis code is missing or invalid for the procedure code.

No action is required of providers. An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. Providers should continue to submit claims in a timely manner and are encouraged to check the Medi-Cal website regularly for updates regarding this issue.