26-742 Provider Communications Posted Online and Operations Manual Updates for May 2026
Date: 06/05/26
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The tables below outline provider communications posted online and operations manual changes made in May 2026.
- 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: Includes the effective date of the change, document name (and path to section where document is located), audience, URL, and a summary of the change.
Communications posted online in May 2026
Date, number and title | Type of notice | Audience | Medi-Cal counties | Summary |
|---|---|---|---|---|
5/13/26 26-610m (PDF), Dyadic Services: Medi-Cal Whole Family Behavioral Health Support | News & Announcements | Physicians/ PPGs Hospitals Ancillary ECM CS Behavioral Health
|
| Learn how dyadic services help improve a child’s behavioral health by caring for the child and their parent or caregiver together. This Medi-Cal behavioral health benefit is available to children and youth under age 21 along with the parent/caregiver, and can help providers identify concerns early, strengthen family relationships, and connect families to needed support. |
5/28/26 26-710m (PDF), Updates to Clinical Policies – April 2026 | Contractual | Physicians/ PPGs Behavioral Health
|
| Review changes to medical policies for procedures and services for April 2026. Medical policies are available online at Medical policies. 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. |
5/29/26 26-719m, Capitation Payments for Newborns: No Separate Payment Until Month 3 | Contractual | Physicians/ PPGs
|
| Find out how Medi-Cal capitation payments are handled for newborns during the month of birth and the following month. Includes the steps providers should take to help ensure payments are processed correctly until the newborn’s individual Client Index Number is established. |
Medi-Cal Provider Operations Manual changes in May 2026
Effective Date | Document name (and path) | Audience1 | Summary |
|---|---|---|---|
5/1/26
|
(under ID Cards) | All | Added a sample of a newly designed Medi-Cal member ID card. Providers must accept both the new and existing ID cards. |
5/12/26
| Requesting Prior Authorization or Coordinating a PCP Referral (under Prior Authorization> | Physicians/ PPGs Hospitals | Updated the standard prior authorization timeline for Medi-Cal only from “seven calendar days” to “the lesser of five business days or seven calendar days” to align with regulations. |
Authorization and Referral Timelines (under Provider Oversight > Service and Quality Requirements) | PPGs
| ||
|
(under Benefits) | All | ||
5/15/26 |
(under Public Programs) | All | Updated youth trauma screening requirements due to regulatory changes. Changes may affect claims reimbursement for providers who screen Medi-Cal members under age 21 for Specialty Mental Health Services access or adverse childhood experiences, effective April 1, 2026. |
5/15/26 | Therapeutic Injections and Other Injectable Substances (PDF) (under Benefits > Injectables) | All | The Injectable Medication HCPCS/DOFR Crosswalk has been updated for the 1st quarter of 2026. |
5/21/26 |
(under Enrollment) | Physicians/ Practitioner PPGs | New document added about the Health Information Form. New members receive the form in the member enrollment packets and are asked to complete it within 90 days of joining the Plan. Direct links to the form (in English and other languages) are available in the operations manual for easy access and reference if members request help to complete it. |
5/21/26 |
(under Quality Improvement) | Physicians/ Practitioners PPGs | Updated the following reference materials in document:
|
5/22/26 |
(under Eligibility) | All | Revised document to clarify that, until the newborn’s individual Client Index Number is established, Medi-Cal capitation payments for the month of birth and the following month are covered under the mother’s eligibility. |
1All – The provider operations manual document applies to physicians/practitioners, PPGs, hospitals and ancillary providers, unless noted otherwise.
If you have questions regarding information contained in this update, contact CalViva Health at 888-893-1569. Behavioral health providers can call 844-966-0298.