25-310 Provider Communications Posted Online and Operations Manual Updates for March 2025
Date: 04/07/25
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 and operations manual changes made in March 2025.
- Communications posted online: Includes the posting date, material number and title, type of notice, applicable audience and lines of business, and a summary of the communication.
- Provider operations manual changes (for physicians, participating physician groups (PPGs), hospitals, and ancillary providers): Includes the effective date of the change, document name (and path to section where document is located), audience, affected lines of business and URLs, and a summary of the change.
- Behavioral Health Provider Operations Manual: Includes the effective date of the change, operations manual section, topic and summary of the change.
Communications posted online in March 2025
Date, number and title | Type of notice | Audience | Lines of business1 | Summary |
|---|---|---|---|---|
3/17/25 25-260m, Help Pregnant and New-Parent Patients Get Workplace Accommodations | News & Announcements | Physicians PPGs Hospitals Ancillary providers CS providers ECM providers Behavioral Health Providers |
| Informs providers how they can help patients obtain pregnancy and childbirth-related accommodations and job protection in the workplace by using the resources in the guide, Leave, Pay and Accommodations for Pregnant and Birthing Workers in California, available at Legal Aid at Work. |
3/20/25 25-258m, Stay Informed About Quality Goals and Activities to Improve Members’ Health | News & Announcements | Physicians PPGs Hospitals Ancillary providers CS providers ECM providers Behavioral Health Providers |
| Provider comparison information on clinical care and service measures between Reporting Years 2023 and 2024. It includes the progress made and improvements that are still needed to improve member health. |
3/20/25 25-273m, Reimbursement Update for Routine Foot Care | News & Announcements | Physicians PPGs Hospitals Ancillary providers |
| Informs providers of new billing guidelines associated with routine foot care. |
3/26/25 25-268m (PDF), Updates to Medicare Clinical and Medical Policies – April 2025 | Contractual | Physicians PPGs Hospitals Ancillary providers Behavioral Health providers |
|
Review changes to Medicare medical policies for procedures and services for April 2025, and to Commercial and Medi-Cal policies for February 2025. 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. |
3/26/25 25-265m (PDF), Medical Policies – | Contractual | Physicians PPGs Behavioral Health providers |
| |
3/26/25 25-287m, Empower Patients to Track Their Child’s Milestones With CDC’s Milestone Tracker App at No Cost | News & Announcements | Physicians PPGs
|
| Learn about the Centers for Disease Control and Prevention’s Milestone Tracker app. Encourage your patients to track their child’s milestones from ages 2 months to 5 years old. |
3/31/25 25-283m, 2025 Mammogram Facility Incentive Program | News & Announcements | PPGs |
| Discover what’s new for the 2025 Mammogram Facility Incentive Program. Find out about payment information, conditions and billing codes. |
3/31/25 25-282m, 2025 Mammogram Facility Incentive Program | News & Announcements | PPGs |
| Discover what’s new for the 2025 Mammogram Facility Incentive Program. Find out about payment information, conditions and billing codes. |
1 Medi-Cal (all counties) indicates that the communication applies to Medi-Cal Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.
Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in March 2025
Effective Date | Document name (and path) | Audience | Lines of business and URL | Summary |
|---|---|---|---|---|
3/1/25
| Transportation (under Benefits > Ambulance) Contacts
Forms and References
| Physicians PPGs Physicians PPGs Hospitals Ancillary Hospitals Ancillary |
Health Net Transportation Vendors Physician Certification Statement Form – Request for Transportation (PDF) | Updates made to information, including to Contacts documents and forms, about the process for requesting non-emergency medical transportation for Medi-Cal members. |
3/5/25 | Home Infusion (under Benefits > Injectables) | Physician PPGs Hospitals Ancillary | Updated to clarify that shared-risk PPGs are no longer under home infusion capitation to Coram, 11/1/22. While Coram is still contracted, PPGs can use any | |
3/18/25 | Health Net Injectable Medication HCPCS/DOFR Crosswalk (PDF) | Physicians PPGs Hospitals Ancillary | Updated the Injectable Medication HCPCS/DOFR Crosswalk for the 4th quarter of 2024. | |
3/24/25 | Capitated Claims Billing Information (under Claims and Provider Reimbursement) | Physician PPGs Hospitals Ancillary |
| Updated to replace references to 300/308 reports with information indicating that claims status can be obtained by logging in to the secure provider portal. |
3/31/25 | Procedures and Requirements, etc. (under Appeals, Grievances and Disputes > Member Appeals) | Physician PPGs Hospitals Ancillary |
| Updated to reflect changes to appeal submissions timelines, per CMS requirements, effective 1/1/25. The changes extend the submission timeframe from 60 to 65 days to provide additional time for members and non-contracted providers to initiate an appeal. |
Behavioral Health Provider Operations Manual changes in March 2025
Effective Date | Section | Topic | Summary |
|---|---|---|---|
3/1/25 | Section 6, Member Access to Practitioners | Transportation for Medi-Cal Members | Updates made to information about the process and forms used when requesting non-emergency medical transportation for Medi-Cal members. |
3/28/25 | Section 12, Billing and Reimbursement | Telehealth Billing Requirements | Updated requirements for behavioral health providers on how to bill for telehealth services. |
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.
For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, Molina, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.