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 2 Update
- Genetically Handicapped Persons Program Reimbursement Process
- May 2025 CCS Service Code Groupings Policy Update
- Update to Medi-Cal Telehealth Policy for Brief Virtual Communications and Check-ins Using CPT Code 98016
- HCPCS Code J9172 Is Now a Medi-Cal Benefit
- TAR Criteria Update for Select PLA Codes
- Policy Update for HCPCS Code J1756
- Coming Soon: Updated Medi-Cal Coverage for Behavioral Health Treatment Services
- Provider Manual Revisions
- Updated ICD-10-CM Codes for HCPCS Code E3200
- 2025 Pediatric Subacute Facilities Reimbursement Rate Update
- Calendar Year 2024 Clinical Laboratory and Laboratory Services Data Collection
- Notification: DRG Payment System Update to Hospital-Acquired Condition V42.1 on April 1, 2025
- Justice-Involved (JI) Reentry Initiative: Correction for FQHC, RHC, Tribal FQHCs and IHSMOA Clinics
- New Public Fee-For-Service Provider Directory: Action Required
- Medically Necessary Gender-Affirming Care Services Covered for Medi-Cal Members
- National Correct Coding Initiative Quarterly Update for 2025: Quarter 2 MUE Replacement Files
- Reminder: Notice of Election Form Requirement for Medi-Cal Hospice Providers
For detailed information regarding these changes, please refer to:
- General Medicine Bulletin 60
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=generalmedicine - Durable Medical Equipment and Medical Supplies Bulletin 596
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=durablemedical-equipment-and-medical-supplies - Long Term Care Bulletin 579
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/publications/bulletin?community=long-termcare - Medi-Cal Newsflashes
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33382.01
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/32984.63
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33062.53
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33457
https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33454
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.