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Provider Update

Provider Update No. 175

Date: February 18, 2025

To: Providers

From: CalOptima Health Provider Network Management

Subject: Procedure Code Updates

Based on Medi-Cal Bulletins and Newsflashes, CalOptima Health has updated the procedure codes and other relevant information for the subjects listed below:

  • Justice-Involved (JI) Reentry Initiative: Laboratory and Radiology Services
  • New Temporary Medi-Cal Benefit Identification Document
  • Presumptive Eligibility Provider Instruction: Erroneous Income Denials for 2025 FPLs
  • Medi-Cal Minor Consent Services
  • Update: The Number of Required Antepartum Visits to Bill for Global Obstetric Care Has Changed
  • Patient Notification Policy Update for Primary Care Providers in the EWC Program
  • Influenza A and B Virus Language Update
  • CPT Code 59412 Now a Medi-Cal Benefit
  • Provider Manual Revisions
  • CMC Rebrand to EDI 837 Transaction
  • New Aid Codes for the County Medical Services Program
  • Injection, Antihemophilic HCPCS Codes Added for Managed Care Plans
  • Updated Policy: Hearing Aid Coverage for Children Program (HACCP)
  • Include ZIP Codes for Medical Transportation Services
  • New Alternative Payment Methodology Program for FQHC Providers
  • Discontinuation of HAP Cards for FPACT with Transition to the CalHEERS Family PACT Portal
  • NPI and HCAI Verification Required for SNF WQIP Providers
  • Newborn Gateway Providers: Preventing Numerous CINs for an Infant
  • Community Clinic Directed Payment Program Application
  • Aid Code 50 Benefit Language Update
  • FS/NF and FS/SA Workforce Standards Program Rates for Calendar Years 2024 and 2025

For detailed information regarding these changes, please refer to:

To access the updated Physician Administered Drug Prior Authorization List (PAD PA List), please refer to

https://www.caloptima.org/en/ForProviders/ClaimsandEligibility/PriorAuthorizations.aspx

 

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