20-508 Learn How to Bill ACEs Screening HCPCS Codes G9919 and G9920
This information applies to Physicians and Participating Physician Groups (PPGs) providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.
Use the answers to your FAQs to avoid rejected claims and get faster payments
The medical plan is responsible for paying HCPCS codes G9919 and G9920 for adverse childhood experiences (ACEs) screening services. The information in this update gives more detail on how to bill these screening services and where to send claims to the medical plan.
HCFA CMS-1500 vs UB04 claim form
Continue to use the form you normally use to bill professional (CMS-1500) or facility (UB04) services.
Mail paper claims to this address
Use the address below to send paper claims through the U.S. Postal Service (USPS):
CalViva Health Claims
PO Box 9020
Farmington, MO 63640-9020
Set up electronic transactions
For faster processing, set up electronic data interchange (EDI) to submit claims and receive electronic payments. Contact Health Net EDI by telephone at 1-800-977-3568 or by email at firstname.lastname@example.org.
You do not need to resubmit claims for G9919 and G9920 even if you have not received payment or either code was denied for participating physician group (PPG) risk. The medical plan is reviewing past claims to make retroactive adjustments for payments that may be due.
Employed or independent clinicians
All impacted providers rendering ACEs specific services must ensure they individually take the state certified training and attest. This applies whether you are an employed or an independent provider.
Note: The June 30 due date for state certified attestations are at the provider level and not the facility level.
Part of a PPG
If you are contracted with a participating physician group (PPG), continue to send claims to the PPG as normal except for ACEs codes G9919 and G9920. Both ACEs codes must be billed directly to the health plan.
Reminders for time-sensitive due dates
Complete state mandatory certified training by end of June 2020
To screen patients for ACEs, providers must complete a two-hour online training that focuses on trauma-informed care, the use of the ACEs questionnaire and the age-appropriate screening tool. Register for the training at https://training.acesaware.org/.
All of the certified ACEs training is validated by the state and the Department of Health Care Services (DHCS). DHCS will set up a website and make reports available which list who completed their certified ACEs training.
Self-attest by July 1, 2020
For continued reimbursement after July 1, 2020, providers must self-attest to DHCS by completing the Trauma Screening Training Attestation form.
ACEs Aware Webinars
The link at the end of this paragraph offers previous webinars provided by ACEs Aware to help you learn more about the initiative and why providers should screen for ACEs. To view existing trainings on trauma-informed care or register for future trainings, visit the ACEs Aware website.
Access the provider updates below in the Provider Library. After you log in at provider.healthnet.com, scroll towards the bottom of the home page and select the Provider Library tile. Or, you can access the Provider Library.
|Provider update||Distribution date||Update number|
|Receive Prop 56 Payments for ACEs Screenings||March 27, 2020||20-319|
|Join ACEs Educational Webinars and Earn CE Credits||May 8, 2020||20-366|
|Use These Guidelines to Improve Trauma-Informed Care to Patients with ACEs||May 22, 2020||20-408|
Providers are encouraged to access the provider portal online at provider.healthnet.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update), contact CalViva Health at 1-888-893-1569.