Provider Update

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

• 2024 HCPCS Quarter 3 Update
• Justice-Involved (JI) Initiative: JI Screening Portal
• Children’s Presumptive Eligibility: Eligibility Determination Assistance Process
• DETEC Application Migrating to the Provider Portal in August
• PLA Code 0330U Benefit Status Change
• Maximum Dispensing Quantity of Select Contraceptives Increased
• List of Contracted Incontinence Creams and Washes Update
• List of Contracted Incontinence Absorbent Products Update
• Clinical Laboratory or Laboratory Services Rates Update
• Reimbursement Rate Change for HCPCS Code J7307
• Children’s Presumptive Eligibility Qualified Provider Enrollment
• Provider Manual Revisions
• 2025 Whole Child Model Transition
• Assistive Robotic Arm Device Now a Medi-Cal Benefit
• Vaccines for Children Now a Medi-Cal Benefit
• COVID-19 Vaccine Administration No Longer Reimbursable for Family PACT
• 2024 Freestanding Pediatric Subacute Facilities Reimbursement Rate Update
• Mailing Address Updated for GHPP
• Effective July 1, 2024: CHDP Is Rebranded as Children’s Presumptive Eligibility
• Policy Update for CPT Codes 90867, 90868 and 90869

For detailed information regarding these changes, please refer to:

• General Medicine Bulletin 602
  https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=general-medicine
• Medi-Cal Program & Eligibility Bulletin 25
  https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=medi-cal-program-and-eligibility
• Durable Medical Equipment and Medical Supplies Bulletin 587
  https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=durable-medical-equipment-and-medicalsupplies
• Pharmacy Bulletin 1057
  https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=pharmacy
• Family PACT Bulletin 20
  https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=family-pact

• Medi-Cal Newsflashes

  https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33026
  https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33034
  https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32590.07
  https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32938

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.