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25-669 Provider Communications Posted Online and Operations Manual Updates for June 2025

Date: 07/07/25

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 June 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 June 2025

Date, number and title

Type of notice

Audience

Medi-Cal counties

Summary

6/9/25

25-562m (PDF), Maximize Your Access and Availability: Join Our No-cost Webinars!

Regulatory

Physicians

PPGs

Ancillary providers

Behavioral Health providers

Fresno

Kings

Madera

Attend one of our 2025 webinars for insight into ways to improve member satisfaction and survey outcomes for access and availability. Find dates, times and a link to register, as well as a list of required access standards for different appointment types, the office phone and in-office wait times.

6/13/25

25-298m, Dyadic Care Services Approved for Reimbursement at Medi-Cal Fee-for-Service (FFS) Rates

News & Announcements

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Fresno

Kings

Madera

On Jan. 6, 2025, the Centers for Medicare & Medicaid Services (CMS) authorized the use of an alternative payment methodology to pay Federally Qualified Health Centers, Rural Health Clinics and Tribal Health Programs at the Medi-Cal fee-for-service rate for dyadic services.

6/18/25

25-590m, Medical Policies –
May 2025

Contractual

Physicians

PPGs

Behavioral Health providers

Fresno

Kings

Madera

Review changes to medical policies for May 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.

6/13/25

25-003m (PDF), Assist Members With Getting Care Fast

Contractual

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Fresno

Kings

Madera

This flyer promotes alternative ways a member can access care outside of seeing care directly from the primary care physician or the emergency room.

6/20/25

25-587m, Accurate Diagnosis Code Placement for Prescriptions Related to Rape and Sexual Assault

Regulatory

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Fresno

Kings

Madera

Clarifies billing guidelines for July 1, 2025, coverage changes due to Assembly Bill 2843. Includes requirements for the correct placement of ICD-10 codes on paper and electronic prescriptions.

6/26/25

25-627m (PDF), Community Supports Authorization Guides and Referral Forms Are Updated to Align With the DHCS

Regulatory

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Fresno

Kings

Madera

Updates have been made to select CS authorization guides and referral forms, effective July 1, 2025. This includes new program overviews, eligibility criteria, required documentation, authorization criteria, allowable providers and more.

 

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

Effective Date

Document name, path (if applicable) and URL

Audience

Summary

6/12/25

 

Maternal Mental Health Screening Requirement


(under Benefits > Maternity)

 

Physicians

PPGs

Hospitals

Ancillary

Added reference to Notification of Pregnancy forms, which can be completed to refer members to pregnancy services and resources. These forms are also available under the Forms and References section.

6/16/25

Health Net Injectable Medication HCPCS/DOFR Crosswalk (PDF)


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

Physician

PPGs

Hospitals

Ancillary

 

Updated the Injectable Medication HCPCS/DOFR Crosswalk for the 1st quarter of 2025.

6/23/25

Provider Marketing Guidelines

(under Compliance and Regulations)

 

Physicians

PPGs

Hospitals

Ancillary

Updated Provider Marketing Guidelines flyers with a revised term, “Notice of Availability” (replacing “Notice of Language Assistance”). The flyers are also available under the Forms and References section.

 

Behavioral Health Provider Operations Manual changes in June 2025

Effective Date

Section

Topic

Summary

6/20/25

Section 3

Confidentiality Standards

Added reference to Medi-Cal Provider Marketing Guidelines with links to flyers that you can download for guidance on creating marketing materials, presentations and displays that mention the Plan’s name, its different plan options or products.

 

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: 07/02/2025