Based on Medi-Cal Bulletins and Newsflashes, CalOptima Health has updated the procedure codes and other relevant information for the subjects listed below:
- Correction: EWC Core Program Performance Indicators Table
- CPT Code 87521: New CLIA-Waived Test
- Minimum Age Requirement Adjusted for Respiratory Syncytial Virus Vaccine
- JYNNEOS Vaccine Reimbursement
- Policy Update for CPT Code 90661
- Age Requirement Removed from Remote Physiologic Monitoring Codes
- Use of the Rates Table for Physician Administered Drugs
- Provider Manual Revisions
- Aid Code 50 Language Update
- November 2024 Updates to CARC and RARC Codes in the RAD Repository
- 2025 Whole Child Model Transition
- 2024-2025 FFS Updates to List of Contracted Tracheostomy Supplies
- Local Educational Agency Billing Option Program Withholds Update
- Notification: DRG Payment System Update to Hospital Acquired Condition V42.0 After October 1, 2024
- SNF WQIP Updates to Select Technical Program Guides and Long Stay Measure
- Justice-Involved Reentry Initiative: Claim Submission and Services Update
- Update: Alternative Payment Methodology for FQHC
- Transition to New Family PACT Portal in January 2025
- Revision to Billing Requirements for Select Abortion CPT Codes
- Policy Update for CPT Code 90661
- Justice-Involved (JI) Reentry Initiative: Updated Q&As for September 2024 Screening Portal Webinars
- Justice-Involved (JI) Reentry Initiative: AEVS with New Aid Codes
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 605
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=generalmedicine - Medi-Cal Program & Eligibility Bulletin 28
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=medi-calprogram-and-eligibility - Durable Medical Equipment and Medical Supplies Bulletin590
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=durablemedical-equipment-and-medical-supplies - Local Educational Agency Bulletin 602
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=localeducational-agency - Medi-Cal NewsFlashes
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33100.01
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33162
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32984.28
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33121
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33148
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33187
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33136.01
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32984.31
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32365.05
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.