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​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Public Notices for 2022 Proposed State Plan Amendments  

​​​​Back to Proposed State Plan Amendments by Year​

These proposed State Plan Amendments (SPAs) would change statewide methods and standards for Medicaid payment rates. All of these SPAs require a Public Notice prior to submission to CMS. All 2022 Public Notice announcements will be published on this webpage when they are available. Once these SPAs are submitted to or approved by CMS they are also posted in the pending or approved SPAs pages. For any questions ​or concerns, please contact PublicInput@dhcs.ca.gov.

  • ​22-0001 Proposes to add community health worker​ services as a Medi-Cal covered benefit. (Released March 11, 2022)​
  • 22-0002 Proposes to add doula services as a Medi-Cal covered benefit and to establish a reimbursement methodology. (Released October 3, 2022)
  • 22-0003​ Proposes to add Asthma Preventive Services as a covered benefit and establish a reimbursement methodology. (Released June 6, 2022)
  • 22-0004​ Proposes to add coverage and provide cost sharing assurances for the treatment and prevention of COVID-19, COVID-19 tests, counseling-only visits for COVID-19 vaccines, and reimbursement for eligible pharmacies administering COVID-19 tests as a covered benefit. (Released July 6, 2022) 
    • ​22-0004 Public Notice Addendum​ - Adds​​ coverage and provides ​cost avoidance assurances ​for the treatment and prevention of COVID-19, COVID-19 tests, counseling-only visits for COVID-19 vaccines, and throughout the American Rescue Plan period. (Released August 11, 2022)
  • 22-0005 Proposes to update the payment methodology for the Outpatient Disproportionate Share Hospital (OP DSH) and Outpatient Small and Rural Hospital (OP SRH) supplemental reimbursement programs. (Released March 22, 2022)​
  • 22-0006​​ Proposes to adjust the Medi-Cal Fee-For-Service (FFS) reimbursement rates for radiology​ services. ​(Released December 29, 2021)
  • 22-0008​ Proposes to ​​adjust the Medi-Cal FFS​ reimbursement rates for durable ​medical equipment. ​(Released December 29, 2021)
  • 22-0009 Addendum​ - Originally released as the SPA 21-0010 Public Notice. Proposes to extend the supplemental payments for Non-Emergency Medical Transportation services funded by Proposition 56 past the current sunset date of December 31, 2021, effective beginning January 1, 2022. ( Addendum r​eleased January 6, 2022)
  • 22-0010​ Proposes to establish a reimbursement methodology for Bio-Engineered ​Substitute (Skin Graft) procedure codes. (Released December 30, 2021)
  • 22-0011 Proposes to renew the Quality and Accountability Supplemental Payment (QASP) Program and to revise the quality measures for the QASP methodology​ for calendar year 2022. (Released December 22, 2021)​​
  • 22-0012​ Proposes to ​renew the reimbursement methodology for Skilled Nursing Facility Level-B and Freestanding Subacute facilities. (Released December 21, 2021)​
  • 22-0013​ Proposes to clarify the healthcare procedure coding system quarterly update process and to amend the reimbursement methodology for non-institutional services. (Released December 29, 2021)​
  • 22-0014 Proposes to permanently continue telehealth services, delivered via synchronous (audio-visual) interaction, synchronous (audio-only) interaction, and asynchronous (store and forward), in the definition of a “visit” and allow services delivered by Associate Clinical Social Worker or Associate Marriage Family Therapist when billed under the license of a behavioral health practitioner at FQHCs, RHCs, and Tribal FQHCs that were initiated during​ the COVID-19 Public Health Emergency. (Released March 13, 2023)​
  • 22-0015​ Proposes to implement the Public Provider Ground Emergency Medical Transport Intergovernmental Transfer Program. (Released May 2, 2022)
  • 22-0016 Public Notice and SPA​​ Proposes to update the Medi-Cal Fee-For-Service reimbursement rates for certain dental services. (Released June 9, 2022)
  • 22-0017​ Proposes to add routine patient costs associated ​with ​participation in qualifying clinical trials ​as a Medi-Cal benefit. (Released December 31, 2021)
  • 22-0019 Proposes to ​add community health worker services, asthma preventive services, and routine patient costs associated with participation in qualifying clinical trials in the Alternative Benefit Plan. (Released June 1, 2022) 
  • 22-0020 Proposes to ​update the Current Dental Terminology (CDT) dental code set to CDT 2022. (Released March 10, 2022)
  • 22-0022 Addendum - Originally released as the SPA 21-0064 Public Notice​. ​Proposes to exempt Durable Medical Equipment Complex Rehabilitation Technology (DME CRT) and Complex Rehabilitation Technology Services (CRTS) from the Assembly Bill (AB) 97 ten percent payment reductions. (Addendum released January 6, 2022)​
  • 22-0025​ Proposes to extend the supplemental reimbursement for Qualified Non-Designated Public Hospitals program to June 30, 2023. (Released June 1, 2022)
  • 22-0026​ Proposes for enhanced payments to private trauma hospitals. (Released May 5, 2022)
  • 22-0027​ Proposes to extend the Supplemental Reimbursement for Qualified Private Hospitals Program to June 30, 2023. (Released May 31, 2022)
  • 22-0028​​ Proposes to adjust the methodology for the hospital-specific DSH limit calculation to conform to federal rules. (Released April 18, 2022) 
  • 22-0029 Public Notice and SPA​ Proposes to update the Medi-Cal reimbursement methodology for State Fiscal Year (SFY) 2022-23 Diagnosis Related Group (DRG) payments. (Released May 20, 2022) ​
  • 22-0032​ Proposes to amend the Targeted Case Management (TCM) reimbursement methodology. (Released September 30, 2022)
  • 22-0034​ Proposes to reduce premiums for the 250 Percent Working Disabled Program to zero dollars. (Released March 28, 2022)
  • 22-0039​ Proposes to exempt certain services and providers from the Assembly Bill 97 payment reductions. (Released June 28, 2022)
  • 22-0040​ Proposes to renew the Ground Emergency Medical Transportation (GEMT) Quality Assurance Fee (QAF) program. (Released June 13, 2022)
  • 22-0043​ Proposes to seek necessary federal approvals to add qualifying community-based mobile crisis intervention services as a covered Medi-Cal behavioral health benefit. (Released October 7, 2022) 
  • 22-0045 Proposes to​ eliminate copayments in the Medi-Cal program. (Released September 23, 2022)
  • 22-0046​​ Proposes to establish a reimbursement rate for the cognitive health assessment benefit. (Released June 30, 2022)​
  • 22-0048 Proposes to make permanent the following Public Health Emergency (PHE)-related flexibilities previously approved by CMS: technology services, self-directed support services, and incentive payments for paid internship programs. (Released August 12, 2022)
  • 22-0051 Proposes to amend the Alternative Benefit Plan by adding doula services as a covered Medi-Cal benefit for the new adult group and adding associate marriage and family therapists and associate clinical social workers as a billable service under the license of an authorized behavioral health practitioner in Federally Qualified Health Centers (FQHCs) and ​Rural Health Clinics (RHCs).​ (Released November 18, 2022)
  • 22-0052​ Proposes to continue augmentation payments for Emergency Medical Air Transportation Services. (Released June 30, 2022)​
  • 22-0053 Proposes to update rate setting methodology for clinical laboratory and laboratory services. (Released June 28, 2022)
  • 22-0054 Proposes to increase the reimbursement rate for the Newborn Screening Program. (Released June 30, 2022)
  • 22-0056 Proposes supplemental payments to eligible hospitals in the Hospital Quality Assurance Fee (HQAF) Program up to the federal upper payment limit. (Released December 21, 2022)
  • 22-0057​ Proposes supplemental payments to eligible hospitals in the HQAF Program up to the federal upper payment limit. (Released December 21, 2022)
  • 22-0058 and SPA Pages​ Proposes to implement rate changes funded in the 2022-23 Budget Act and informed by the 2019 service provider rate study regarding the 1915(i) State Plan​. (Released August 19, 2022)​
  • 22-0060​ Proposes to clarify Los Angeles County hospitals’ use of the relative value unit system to apportion hospital costs to Medi-Cal. ​(Released September 29, 2022)
  • 22-0061​ Proposes to update the reimbursement methodology for Intermediate Care Facilities for the Developmentally Disabled including Habilitative and Nursing Facilities. (Released July 26, 2022) 
  • 22-0062 Proposes to establish reimbursement rates for monkeypox vaccine administration. (Released August 16, 2022)​
  • 22-0063​ Proposes to increase reimbursement rates for the Prenatal Screening Program. (Released September 16, 2022)
  • 22-0064​ Public Notice and SPA​ Proposes to adjust the reimbursement rates for the Prenatal Screening Program's cell-free DNA (cfDNA) screening using Current Procedural Terminology code 81420​. (Released September 29, 2022)​
  • 22-0065 Proposes to align the Medi-Cal reimbursement rate for all physician ad​ministered drugs to the Medicare physician fee schedule.​ (Released September 28, 2022)
  • 22-0066 Proposes to  increase Medi-Cal FFS reimbursement rates for acupuncture services. (Released November 8, 2022)​
  • 22-0067​ Proposes to continue supplemental payments to FQHCs, RHCs, Indian Health Service-Memorandum of Agreement, and Tribal FQHCs for COVID-19 vaccine-only visits following the end of the PHE​​. (Released December 9, 2022)
  • 22-0072 Proposes to exempt guaranteed income as income and resources for Medi-Cal eligibility purposes. (Released November 29, 2022)
  • 22-0073 Proposes to maintain current FFS Medi-Cal rates for Durable Medical Equipment (DME), considered to be oxygen and respiratory equipment, following the end of the PHE​.​ (Released December 28, 2022)
    • ​22-0073 Public Notice Addendum​ - ​​Clarifies the DME reimbursement rates on or after January 1, 2024, and rescinds the provisions of Disaster SPA 21-0016. (Released February 7, 2023)
Last modified date: 3/17/2023 10:54 AM