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: Behavioral Health Codes Available for Provider Types
- Justice-Involved (JI) Reentry Initiative: Type of Bill 086x for DMC and DMC-ODS Providers
- Justice-Involved (JI) Reentry Initiative: JI Microlearning Videos Section Available
- Fourth Quarter Rate Update for Select Contraceptive HCPCS Codes
- Policy Update for HCPCS Codes Q9996 and Q9997
- Provider Resource: California Child and Adolescent Mental Health Access Portal
- Updates to Intermittent Urinary Catheters and Medical Supplies Billing Codes, Units and Quantity Limits
- Codes 0211U and 0487U Are New Medi-Cal Benefits
- PLA Code 0421U Is a New Medi-Cal Benefit
- TAR and Nonstandard Benefits Clarification
- Clarification on Documentation Requirements for Select Doula Codes
- Important Coverage Update: Effective January 1, 2026, Medi-Cal Will No Longer Cover FDA-Approved GLP-1 Medications
- Provider Manual Revisions
- Update: Medi-Cal Adult Expansion Freeze Begins January 2026
- New PACE Managed Care Plans
- HCPCS Code E0483 Is Non-Taxable
- Update to the List of Contracted Advanced Wound Care Products and the List of Medical Supplies Billing Codes, Units and Quantity Limits
- 2025 Administrative Day, DP/NF-B and Rural Swing Bed Rate Update
- Calendar Year 2025 Distinct-Part Adult Subacute Annual Rate Update
- Long-Term Care Rates Are Available for Calendar Year 2026
- National Correct Coding Initiative Quarterly Update for October 2025: EPC Implementation Date Change
- Prevention of Duplicate Records for the Every Woman Counts Program
- BCCTP Medi-Cal Changes for Individuals Without SIS
- Justice-Involved (JI) Reentry Initiative: FQHC and RHC One-Time Timeliness Override
- Hospital Presumptive Eligibility: New Prescreening Requirement Begins January 1, 2026
- CCMF Update Impacts AEVS Transactions for Medicare Advantage Plan Names
For detailed information regarding these changes, please refer to:
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33743
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/31896.15
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33754
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33762
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32984.97
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33788
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33617
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.