Based on Medi-Cal Bulletins and Newsflashes, CalOptima Health has updated the procedure codes and other relevant information for the subjects listed below:
- 2025 HCPCS Quarter 1 Update
- Update: Change in Procedure for Infants Enrolled Through the Newborn Gateway
- Updated Reimbursement Rates for Electrocardiogram Procedure Codes
- HCPCS Code J0911 Is a Medi-Cal Benefit
- Update to Palliative Care CPT Codes 99490 and 99491
- ICD-10-CM Codes No Longer Required for Select Abortion Codes
- Update for Select Transcranial Magnetic Stimulation CPT Codes
- Provider Manual Revisions
- New PACE Managed Care Plans
- Select Durable Medical Equipment (DME) Codes Are Medi-Cal Benefits
- HCPCS Codes E0691 and E0694 Now a Medi-Cal Benefit
- National Correct Coding Initiative Quarterly Update for January 2025
- Updated Recipient Enrollment Application for Every Woman Counts Program
- Action Required: Unregistered Providers Must Register in the Medi-Cal Provider Portal
- Justice-Involved (JI) Reentry Initiative: Updated Q&As for September and November 2024 Webinars
- Policy for Skilled Nursing Facility Accountability Sanctions Program
- Mandatory Enrollment for Foster Youth in Single Plan Counties in 2025
- 2025 Whole Child Model Transition
- Reminder: Include ZIP Codes for Medical Transportation Services
- DME and Medical Supplies for Recipients Impacted by Wildfires
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 607 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=generalmedicine
- Medi-Cal Program & Eligibility Bulletin 30 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=medi-calprogram-and-eligibility
- Audiology and Hearing Aids Bulletin 592 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=audiologyand-hearing-aids
- Durable Medical Equipment and Medical Supplies Bulletin592 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=durablemedical-equipment-and-medical-supplies
- Medi-Cal Newsflashes
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/31896.08
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33231
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33062.19
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32984.44
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33256
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33128.01
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32972.02
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33268
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33284
To access the updated Physician Administered Drug Prior Authorization List (PAD PA List), please refer to
https://www.caloptima.org/en/For-Providers/Claims-and-Eligibility/Prior-Authorizations.