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Medi-Cal Providers Medi-Cal provides no-cost or low-cost health insurance for Californians, offering vital health care services including doctor visits, prescriptions, vaccinations, and mental health care
Medi-Cal: Login to Medi-Cal State of CaliforniaWARNING: This computer system is for official use by authorized users and may be monitored and or restricted at any time Confidential information may not be accessed or used without authorization Unauthorized or improper use of this system may result in administrative discipline, civil and or criminal penalties By using this system, you are acknowledging and consenting to
Share of Cost (SOC) - Medi-Cal All medically necessary health services – including medical services, supplies, devices and prescription drugs, whether Medi-Cal covered or not – can be used to meet Share of Cost for Medi-Cal and County Medical Services Program (CMSP) purposes
Aid Codes Master Chart (aid codes) - Medi-Cal The aid codes in this chart are meant to assist providers in identifying the types of services for which Medi-Cal and public health program recipients are eligible The chart includes only aid codes used to bill for services through the Medi-Cal claims processing system and for other non-Medi-Cal programs that need to verify eligibility through AEVS
Revenue Codes for Inpatient Services (rev cd ip) - Medi-Cal Diagnosis-Related Groups (DRG) In July 2013 Medi-Cal adopted a diagnosis-related groups (DRG) reimbursement methodology for inpatient general acute care hospitals that do not participate in certified public expenditure reimbursement DRG is a reimbursement methodology that uses information on the claim form (including revenue codes, diagnosis and procedure codes, patient’s age, discharge
Treatment Authorization Request (TAR) - Medi-Cal Family PACT providers request authorization using a Treatment Authorization Request (TAR) form ‹‹TARs, with documentation of medical necessity, are used to obtain authorization for complication services, and for services that exceed the limitations noted, including drugs ››
TAR AUTHORIZATION - Medi-Cal Complete the TAR and ensure that the medical documentation you are submitting with the TAR specifically supports the medical necessity of the requested service
Abortions (abort) - Medi-Cal Commitment to FDA-required recipient education and follow-up to confirm that complete termination of pregnancy has occurred and to evaluate the degree of bleeding Termination can be confirmed by medical history, clinical examination, hCG testing or ultrasonographic scan
TAR Completion (tar comp) - Medi-Cal Physicians, podiatrists, pharmacies, medical supply dealers, outpatient clinics and laboratories use the Treatment Authorization Request (TAR, 50-1) to request approval from a Medi-Cal consultant for certain procedures services