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Provider Update

Provider Update No. 179

Date: June 16, 2025

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:

  • Rate Updates for Select Contraceptive HCPCS Codes
  • 2025 Skin Substitute Rate Update
  • Medi-Cal Coverage for Behavioral Health Treatment Services
  • 2025–2026 EFT Check Write Schedule
  • CPT Codes 92622 and 92623 are Medi-Cal Benefits
  • Updates to Wound Care Medical Supplies
  • Medi-Cal Coverage for Behavioral Health Treatment Services
  • Freestanding Skilled Nursing Facilities Reimbursement Rates for Calendar Year 2024
  • Freestanding Skilled Nursing Facilities Reimbursement Rates for Calendar Year 2025
  • Freestanding Skilled Nursing Facility and Adult Subacute Units Calendar Year 2025 and 2024 Rates Update
  • Reminder: Providers to Inform Family PACT Clients of HAP ID Activation
  • May 2025 SNF Workforce and Quality Incentive Program Updates
  • Coming Soon: Psychological Associate Services Reimbursable for FQHC, RHC and Tribal FQHC Providers
  • New Breast and Cervical Cancer Treatment Program User Guide
  • EWC Self-Collection HPV Testing
  • National Correct Coding Initiative Quarterly Update for July 2025

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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