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 Reentry Initiative: Reimbursable Claim Forms for CBO and LHJ Providers
- PAD Provider Manuals Converted to Excel and New Sections Added
- First Quarter Rate Update for Select Contraceptive HCPCS Codes
- 2026 Income Eligibility Guidelines for Every Woman Counts Program
- ICD-10-CM Code Update for CPT Codes 83001 and 83002
- 2020 Quarterly Medical Policy Update for Select ICD-10-CM Codes
- New Modifiers for CPT Codes 93297 and 93298
- TAR Criteria Updated for PLA Code 0340U
- Miudella Copper IUS Contraception Added as Medi-Cal and Family PACT Benefit
- PLA Codes 0562U, 0569U and 0570U are Medi-Cal Benefits
- TAR Criteria Update for CPT Code 81455
- Administrative Days Policy Clarification for Subacute Care Programs
- Reminder: County Code Does Not Affect Medi-Cal Fee-for-Service Eligibility
- DME Code E0297 Benefit Status Change
- 2026 Freestanding Skilled Nursing Facility Level B Rates Update
- New Remittance Advice Detail Code 9203
- Update: Online Medi-Cal Hospice Program Attestation Form Requirement
- Family PACT Update: FDA Approves Updated Nexplanon Label and Launches New REMS
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 621
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=general-medicine - Medi-Cal Program & Eligibility Bulletin 44
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=medi-cal-program-and-eligibility - Durable Medical Equipment and Medical Supplies Bulletin 606
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=durable-medical-equipment-and-medical-supplies - Long Term Care Bulletin 589
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=long-term-care - Medi-Cal NewsFlashes
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33614.05
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33862
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33923
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
.