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25-313 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 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: 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

Medi-Cal counties

Summary

3/17/25

25-261m, Help Pregnant and New-Parent Patients Get Workplace Accommodations

News & Announcements

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Fresno

Kings

Madera

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

25-259m, Stay Informed About Quality Goals and Activities to Improve Members’ Health

News & Announcements

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Fresno

Kings

Madera

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.

3/26/25

25-266m (PDF), Medical Policies – February 2025

Contractual

Physicians

PPGs

Behavioral Health providers

Fresno

Kings

Madera

Review changes to medical policies for procedures and services for February 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.

3/26/25

25-285m, Empower Patients to Track Their Child’s Milestones With CDC’s Milestone Tracker App at No Cost

News & Announcements

Physicians

PPGs

 

Fresno

Kings

Madera

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.  

3/27/25

25-284m, Elevate Care: Help Your Patients Prevent the Onset of Type 2 Diabetes

Regulatory

Physicians

PPGs

ECM providers

CS providers

Fresno

Kings

Madera

Discover what’s new for the 2025 Mammogram Facility Incentive Program. Find out about payment information, conditions and billing codes.

 

Medi-Cal Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in March 2025

Effective Date

Document name, path (if applicable) and URL

Audience

Summary

3/1/25

 

Transportation

(under Benefits > Ambulance)

Contacts

Forms and References

Physician Certification Statement Form – Request for Transportation (PDF)

Physicians

PPGs

Hospitals

Ancillary

Updates made to information, including to Contacts documents and forms, about the process for requesting non-emergency medical transportation for Medi-Cal members.

3/18/25

Health Net Injectable Medication HCPCS/DOFR Crosswalk (PDF)

(under Benefits > Injectables > Therapeutic Injections and Other Injectable Substances)

Physicians

PPGs

Hospitals

Ancillary

Updated the Injectable Medication HCPCS/DOFR Crosswalk for the 4th quarter of 2024.

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
Plan-contracted home infusion providers, not only Coram CVS Specialty Infusion Services.

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.

 

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.

 

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.



Last Updated: 04/04/2025