25-216 Provider Communications Posted Online in February 2025 and Operations Manual Updates for January 2025
Date: 03/06/25
Access the Provider Library for the latest operational and Plan updates and changes to better service your patients
The tables below outline provider communications posted online in February 2025, and operations manual changes made in January 2025.
- Communications posted online: Includes the posting date, material number and title, type of communication, applicable audience and counties, and a summary of the communication.
- Medi-Cal Provider Operations Manual changes (for physicians, participating physician groups (PPGs), hospitals, and ancillary providers): Includes the effective date of the change, document name, path to section where document is located, URLs, audience and a summary of the change.
- Behavioral Health Provider Operations Manual: No changes were made to this manual for February 2025.
Communications posted online in February 2025
Date, number and title | Type of notice | Audience | Medi-Cal counties | Summary |
|---|---|---|---|---|
2/14/25 25-190m, View Updated Medi-Cal Provider Materials Online | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | CalViva Health Medi-Cal provider materials have been updated and are available on the New Provider Onboard Materials page. Access the page for the Medi-Cal Operations Guide, Save Time Navigating the Provider Portal brochure, the No-cost Interpreter Services flyer, and more. |
2/18/25 25-161m, Support Members Enrolled in ECM Prior to Release from Correctional Facilities | Regulatory | ECM providers | Fresno Kings Madera | Enhanced Care Management (ECM) providers must follow the Justice Involved Initiative requirements when supporting eligible members assigned to them, prior to and immediately following release from correctional facilities. |
2/21/25 25-173m, Medical Policies – January 2025 | Contractual | Physicians PPGs Behavioral Health providers | Fresno Kings Madera | Review changes to medical policies for procedures and services for January 2025. Medical policies, available online at Medical Policies, offer guidelines for determining medical necessity for certain procedures, equipment and services. As a reminder, all services must be medically necessary, and member benefits, legal and regulatory mandates take precedence over content of medical policies and must be applied first. |
2/21/25 25-158m (PDF), Follow Access to Care Standards to Ensure Patients Get Timely Care | Regulatory | PPGs
| Fresno Kings Madera | Review this update to ensure you maintain compliance with various access standards, and know when to authorize an out-of-network provider for members who require medically necessary care. |
Medi-Cal Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in January 2025
The following update was made to the Provider Operations Manual at the end of January 2025. This update was not part of the January 2025 provider communication (25-120) based on the timing of the change. No changes were made to the Provider Operations Manual in February 2025.
Effective Date | Document name, path (if applicable) and URL | Audience | Summary |
|---|---|---|---|
1/30/25 |
(under Benefits) | Physicians PPGs Hospitals Ancillary | Updated to include information about the availability of Applied Behavioral Analysis (ABA) Forms in the Provider Library. Providers may use these forms to refer and/or request ABA treatment for members. |
Provider Services
Line of business | Phone number |
|---|---|
CalViva Health Medi-Cal | |
Behavioral Health providers |
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, Enhanced Care Management (ECM) Providers, and Behavioral Health Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.