Attachment 4.19-B (Pages 1-84)
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Methodology for Establishing Payment Rates (pgs. 1-5)
Targeted Case Management (pgs. 5a-5k)
Federal Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) (pgs. 6-11)
Payment Home Health Agency Services, Dental Services, and Live Transmissions in the Medi-Cal Dental Program (pgs. 20-20c)
Reimbursement for Short-Doyle/Medi-Cal Services, SMA Methodology, and Medi-Cal Personal Care Services (pgs. 21-37)
Reimbursement for Drug Medi-Cal Services (pgs. 38-41f)
Reimbursement Methodology For Sign Language Interpreter Services For the Hearing-Impaired and Supplemental Reimbursement for the Outpatient General Acute Care Hospital (pgs. 43-51c)
Reimbursement for Eligible Government-Operated Hospitals For Professional Services (pgs. 52-65)
Community First Choice Option Services (page 66)
Payment Adjustment for Provider-Preventable Conditions (pgs. 67-68)
1915i Home and Community Based Services - Description of Rate Methodologies (pgs. 69-77)
Physician Services Reimbursement - Increased Primary Care Service Payment (pgs. 78-80)
Outpatient Disproportionate Share Hospitals Supplemental Payments (pgs. 81-86)
Supplements to Attachment 4.19-B
Supplement 1 Payment of Medicare Part A, B, and C Deductible/Coinsurance
Supplement 2 Payment Methodology for Prescription Drugs
Supplement 3 Federal Financial Participation Under New Federal Drug Rebate Program
Supplement 4 Policy and Methods for Establishing Payment Rates
Supplement 5 Cost-Based Reimbursement
Supplement 6 Reimbursement for Indian Health Services and Tribal 638 Health Facilities
Supplement 7 Provider Based Rural Health Clinics
Supplement 8 Payment for Local Education Agency (LEA) Services
Supplement 9 Reimbursement to State-Owned Health Care Clinics For Medi-Cal Beneficiaries
Supplement 10 Public Freestanding Outpatient Clinics Supplemental Payment
Supplement 12 Supplemental Reimbursement for Hospital Outpatient Services
Supplement 13 Supplemental Reimbursement for Hospital Outpatient Services
Supplement 14 Supplemental Reimbursement for Hospital Outpatient Services
Supplement 15 Outpatient Providers Subject to Provider Payment Reductions
Supplement 16 Reimbursement for Emergency Air Medical Transportation Services
Supplement 17 Non-Institutional Services
Supplement 18 Supplemental Reimbursement For Publicly Owned or Operated Ground Emergency Medical Transportation Providers
Supplement 19 Payments to Primary Care Providers: Crosswalk of Evaluation and Management Codes and Local Codes
Supplement 20 Payments to Primary Care Providers: Vaccine Crosswalk
Supplement 21 Payments to Primary Care Providers: CHDP Health Assessment and Immunization Crosswalk
Supplement 22 Supplemental Reimbursement for Hospital Outpatient Services
Supplement 23 One-time Supplemental Payment for Specified Providers
Supplement 24 Supplemental Payments for Hospital Outpatient Services
Supplement 25 One-year supplemental payment for certain dental services using California Healthcare, Research and Prevention Tobacco Tax Act funds
Supplement 26 Allows for time-limited supplemental reimbursements under the Family Planning, Access, Care and Treatment
(Family PACT) program for the Evaluation and Management portion of office visits rendered for the purpose of comprehensive family planning services
Supplement 27 One-Year Supplemental Payment Program for Certain Physician Services
Supplement 28 Time-Limited Supplemental Payments for Family Planning, Access, Care and Treatment Program Services
Supplement 29 One-Year Reimbursement Rate Add-on for Ground Emergency Medical Transport Services
Supplement 30 Supplemental Payments for Specific Family Planning Services Under the Medi-Cal Program
Supplement 32 Supplemental Incentive Payments for Trauma Screenings
Supplement 33 Reimbursement Methodology for Diabetic Prevention Program Services
Supplement 34 Time-Limited Supplemental Payment Program for Non-Emergency Medical Transportation Services
Supplement 35 Supplemental Payments for Hospital Outpatient Services
Supplement 37 California Advancing and Innovating Medi-Cal (CalAIM) Supplemental Payments for Certain Preventive Dental Services and Certain Dental Exam Services
Supplement 38 Supplemental Payments for Hospital Outpatient Services
