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 4 Update
- Newborn Gateway: Reminder on How to Inform Families
- Select Injections No Longer Reimbursable for Licensed Midwives
- Surgery CPT Codes 54401 and 54405 Update
- Policy Update for CPT Code 90683
- ICD-10-CM Diagnosis Codes Required for Doula Services
- Updated Licensed Midwives Billing Codes
- Policy Updated for HCPCS Code J9205
- Billing Requirement Updated for Abortion CPT Codes 59820, 59821, 59840 and 59841
- TAR Requirement and Frequency Limit Removed for CPT Codes 95115 and 95117
- Policy Update for Telehealth E-Consult Services
- Updated Mailing Addresses for GHPP
- Provider Manual Revisions
- TAR Requirement Update for Repairs on CRT Power Wheelchairs
- Annual FQHC and RHC Medicare Economic Index Percentage Increase
- CBAS Provider Assistance Phone Number Updated
- NPs, PAs and CNSs Can Prescribe HHA Services
- Reminder for Split Billing Inpatient Services
- Licensed Midwife Billing Training in October 2024
- CHDP Gateway Is Rebranded as Children’s Presumptive Eligibility
- 2025 ICD-10-CM/PCS Codes Update
- DRG Payment System Update to Mapper V42.0 After October 1, 2024
- Long Term Care Code and Claim Form Conversions: Share of Cost Reminders
- December 2024 Opt-In Deadline for SNF Workforce Standards Program
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 604
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=generalmedicine, - Durable Medical Equipment and Medical Supplies Bulletin 589,
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=durablemedical-equipment-and-medical-supplies - Community-Based Adult Services Bulletin 601
https://mcweb.apps.prd.cammis.medical.ca.gov/publications/bulletin?community=communitybased-adult-services, - Home Health Agencies/Home and Community-Based Services Bulletin 601
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=homehealth-agencieshome-and-community-based-services, - Inpatient Services Bulletin 601
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=inpatientservices - Medi-Cal NewsFlashes
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33086
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32590.10
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33103
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33100
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33127
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33138
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.