Based on Medi-Cal Bulletins and NewsFlashes, CalOptima Health has updated the procedure codes and other relevant information for the subjects listed below:
- CCS Service Code Groupings Policy Update
- PLA Code 0344U Benefit Status Change
- Rate Updates for HCPCS Codes J7304-U1, J3490-U6 and J3490-U8
- Policy Update for HCPCS Code C9482
- HCPCS Code J1447 Policy Update
- Updated Coverage and Reimbursement Policy for Penile Prostheses and Breast Implants
- Medi-Cal Hospice Reimbursement Rates Update for 2023–2024
- National Correct Coding Initiative Quarterly Update for July 2024
- The Newborn Gateway to Launch in July 2024
- Children’s Presumptive Eligibility Qualified Provider Enrollment
- Provider Manual Revisions
- Specialty Mental Health Services Modified for Sacramento and Solano Counties
- Corrections Made to Durable Medical Equipment Codes
- LPCCs Added as Reimbursable Code Set for Tribal FQHC Providers
- Calendar Year 2024 Distinct Part Pediatric Subacute Facilities Reimbursement Rate Update
- Bridge Period Nursing Facilities-Level A Reimbursement Rate Update
- Updated BCCTP Physician Statement and Certification Form
- Mpox Vaccine No Longer a Benefit for FQHC, RHC, IHS-MOA and Tribal FQHC Provide
- Reminder: National Drug Code for Nexplanon
- Update to the Transition to New CalHEERS Family PACT Portal
- Family PACT Program Update: 2024 Income Eligibility Guidelines
- 2024 Income Eligibility Guidelines for the Family PACT Program 4/1/2024
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 600: https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=general-medicine
- Medi-Cal Program & Eligibility Bulletin 23: https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=medi-cal-program-and-eligibility,
- Durable Medical Equipment and Medical Supplies Bulletin 585:
https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=durable-medical-equipment-and-medicalsupplies - Clinics and Hospitals Bulletin 597:https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=clinics-and-hospitals
- Long-Term Care Bulletin 568: https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=long-term-care
- Medi-Cal NewsFlashes:
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32256
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32282
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32487
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32510
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32712.01
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32712.03
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.