Based on Medi-Cal Bulletins and NewsFlashes, CalOptima Health has updated the procedure codes and other relevant information for the subjects listed below:
- 2026 HCPCS Quarter 1 Update
- ICD-10-CM Diagnosis Codes for Intimate Partner Violence
- CPT Code 38228 Rate Update for CAR-T Services
- Update for Select ICD-10-CM/PCS Codes for Quarterly 2024
- Update: Children’s Presumptive Eligibility Worksheet
- Global Obstetrical Billing Update
- PLA Codes 0402U and 0455U Updated to Medi-Cal Benefits
- Documentation Requirements Changed for Prenatal Screen Follow-Up and Diagnostic Testing Services
- PLA Codes 0134U and 0356U Are Medi-Cal Benefits
- Select Biomarker Testing PLA Codes Are Now Medi-Cal Benefits
- Medi-Cal Provider Training Webinars for January and February 2026
- Provider Manual Revisions
- Updated Reimbursement Requirements for Select Psychiatric Hospital Services
- 2026 Distinct-Part Pediatric Subacute Facilities Reimbursement Rate Update
- 2026 Freestanding Pediatric Subacute Facilities Reimbursement Rate Update
- CPT Code 87626 is a Family PACT Benefit
- HCPCS Codes A4295, A4296 and A4297 Added as Medi-Cal Benefits
- National Correct Coding Initiative Quarterly Update for January 2026
- Skilled Nursing Facility Accountability Sanctions Program Policy
- Reimbursement Rate Rescinded for HCPCS Code S5552
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 619
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=general-medicine - Inpatient Services Bulletin 616
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=inpatient-services - Long Term Care Bulletin 587
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=long-term-care - Family PACT Bulletin 220
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=family-pact - Medi-Cal NewsFlashes
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33733.01
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/31896.16
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33822
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33746.01
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.