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Provider Update

Provider Update No. 169

Date: August 16, 2024

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:

  • 2024 HCPCS Quarter 3 Update
  • Justice-Involved (JI) Initiative: JI Screening Portal
  • Children’s Presumptive Eligibility: Eligibility Determination Assistance Process
  • DETEC Application Migrating to the Provider Portal in August
  • PLA Code 0330U Benefit Status Change
  • Maximum Dispensing Quantity of Select Contraceptives Increased
  • List of Contracted Incontinence Creams and Washes Update
  • List of Contracted Incontinence Absorbent Products Update
  • Clinical Laboratory or Laboratory Services Rates Update
  • Reimbursement Rate Change for HCPCS Code J7307
  • Children’s Presumptive Eligibility Qualified Provider Enrollment
  • Provider Manual Revisions
  • 2025 Whole Child Model Transition
  • Assistive Robotic Arm Device Now a Medi-Cal Benefit
  • Vaccines for Children Now a Medi-Cal Benefit
  • COVID-19 Vaccine Administration No Longer Reimbursable for Family PACT
  • 2024 Freestanding Pediatric Subacute Facilities Reimbursement Rate Update
  • Mailing Address Updated for GHPP
  • Effective July 1, 2024: CHDP Is Rebranded as Children’s Presumptive Eligibility
  • Policy Update for CPT Codes 90867, 90868 and 90869

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/For-Providers/Claims-and-Eligibility/Prior-Authorizations.

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