Based on Medi-Cal Bulletins and Newsflashes, CalOptima Health has updated the procedure codes and other relevant information for the subjects listed below:
- Update: The Number of Required Antepartum Visits to Bill for Global Obstetric Care Has Changed
- PLA Codes 0118U and 0493U Updated to a Medi-Cal Benefit
- Presumptive Eligibility Provider Update: 2025 FPL Programming Complete
- March 2025 CCS Service Code Groupings Policy Update
- Rate Updates for Select FPACT HCPCS Codes
- Rate Update for Specific Contraceptive HCPCS Codes
- Policy Update for HCPCS Codes Z7500 and Z7516
- Clarified Medi-Cal Policy for Doula Services
- 2025 Income Eligibility Guidelines for Every Woman Counts Program
- March 2025 Update to AEVS: Carrier Codes for Other Health Coverage
- Select DME HCPCS Codes are Non-Taxable
- Update: Add-On Reimbursement Rate for PP-GEMT IGT Program
- EWC DETEC Breast and Cervical Data Cycles Entry
- February 2025 Update: Select SNF WQIP Finalized Policy Letters and Qualifying List
- National Correct Coding Initiative Quarterly Update for 2025: MUE Replacement Files
- Justice-Involved (JI) Reentry Initiative: Updated Q&As for October 2024 and January 2025 Webinars
- Community Clinic Directed Payment Program: Extended Deadline and Tribal Health Instructions
- 2025 Rate Increase for Home and Community-Based Services Waivers and Programs
- Reporting Year 2026 Payment Error Rate Measurement Review
- Clarification on Billing Guidelines for Medi-Cal Providers for Street Medicine
- HPE Off-Premises Flexibilities
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 608 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=general-medicine
- Medi-Cal Program & Eligibility Bulletin 32 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=medi-cal-program-and-eligibility
- Durable Medical Equipment and Medical Supplies Bulletin 594 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=durable-medical-equipment-and-medical-supplies
- Medical Transportation Bulletin 594 https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=medical-transportation
- Medi-Cal Newsflashes
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33340
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33345
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/31896.09
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32984.52
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33330.02
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33339
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33317
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/31526
- https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/31240
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