Pregnancy Coverage During the COVID-19 Public Health Emergency

Medi-Cal beneficiaries who are in pregnancy related, limited and restricted scope, aid codes continue to retain eligibility for non-pregnancy related services beyond the end of their postpartum period during the COVID-19 Public Health Emergency (PHE). This article provides clarification to eligibility information provided in Provider Bulletin 569 and News Flash posted November 3, 2021. Providers are advised to continue to provide beneficiaries in pregnancy related aid codes with any medically necessary service through the duration of the PHE. Medically necessary services include services that are not related to pregnancy and non-emergency services. Providers should submit claims using the appropriate diagnosis codes in addition to the pregnancy diagnosis code. No claim will be denied for medically necessary services that are not pregnancy related.

Questions concerning eligibility under pregnancy-related aid codes during the PHE should be sent to Pregnancy@dhcs.ca.gov.