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Provider Update

Provider Update No. 182

Date: September 16, 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:

  • Participating Counties for Medi-Cal County Inmate Program Update
  • Justice-Involved (JI) Reentry Initiative: Billing Clarification for CHW Services
  • Third Quarter Family PACT HCPCS Code Rate Updates
  • Policy Update for HCPCS Code J3490 for FPACT and Medi-Cal Family Planning Programs
  • Cell and Gene Therapy HCPCS Code J3392 New Effective Date
  • Update: Contracted Medi-Cal Fee-For-Service Tracheostomy Supplies
  • CPT Code 90382 is Reimbursable for Billing Enflonsia
  • Relocation of Select Policy in Evaluation and Management
  • Provider Manual Revisions
  • There is no bulletin articles published for this community for the month of September 2025.
  • 2025 FQHC and RHC Medicare Economic Index Percentage Increase
  • Contracted Advanced Wound Care Supplies in the List of Billing Codes, Units and Quantity Limits Has Been Updated
  • Dyadic Services Modifiers Update
  • National Correct Coding Initiative Quarterly Update for October 2025
  • New Sterilization Consent Form Available in October 2025
  • Provider Portal Registration for DMC and DMC-ODS Providers
  • Correction to CLIA-Waived Test Reimbursement for Pharmacy Providers

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/for-providers/claims-and-eligibility/prior-authorizations.

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