Provider Update

Provider Update No. 183

Date: October 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:

  • 2025 HCPCS Quarter 4 Update
  • Frequency Change for Select CPT Codes
  • Select Laboratory Test Codes Are Now Medi-Cal Benefits
  • Justice-Involved (JI) Reentry Initiative: Live Training Webinars in October 2025
  • Reminder and Clarification: Medi-Cal Coverage and Billing Policy for Non-Invasive Prenatal Screening Laboratory Tests
  • Sterilization Consent Form Update
  • Provider Manual Revisions
  • Medi-Cal Adult Expansion Freeze Begins January 2026
  • October 2025 Update to AEVS: Carrier Codes for Other Health Coverage
  • Family PACT Update Allows One Site Certifier for Multiple Service Locations
  • Family PACT Live Training Webinar in October 2025
  • Important September 17, 2025, Update: H.R. 1 - Federal Payments to Prohibited Entities
  • FS/NF and FS/SA Workforce Standards Program Rates for Calendar Years 2024 and 2025
  • Ordering, Referring and Prescribing (ORP) Web Page No Longer Available
  • Updates to the Medi-Cal List of Contracted Incontinence Creams and Washes
  • Coming Soon: New Online Hospice NOE Submission Form and Process
  • Updates to the Medi-Cal List of Contracted Incontinence Absorbent Products
  • Calendar Year 2026 LTC Rates Public Review
  • Provider Dispute Resolutions with Managed Care Plans
     

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/ForProviders/ClaimsandEligibility/PriorAuthorizations.aspx.

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