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COVID-19 Information for Providers
Member Support
Alliance Medi-Cal members who get their COVID-19 booster when they are eligible can get a $50 Target gift card. Learn more on our booster shot landing page for members.
To address commonly asked questions from members, the Alliance has developed the COVID-19 webpage for members. We have also provided our member-facing staff with talking points to help them answer questions. We will continue to update these materials as new information becomes available.
Members are encouraged to contact their provider to discuss their symptoms and next steps. If members are unable to reach their provider, we are encouraging them to contact the Alliance's 24-hour Tus Xov Tooj Nug Kev Pab Los Ntawm Tus Kws Tu Neeg Mob (Nurse Advice Line; NAL, raws li sau hauv lus Askiv) to speak to a registered nurse. The number is 844-971-8907.
Medi-Cal members and Alliance Care IHSS members can get medications delivered through mail order pharmacies. One mail order pharmacy option is SortPak. You can contact SortPak Pharmacy at 877-570-7787 for more information. Read the sections below for information specific to Medi-Cal members and Alliance Care IHSS members.
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Members can use any mail order pharmacy that is contracted with Medi-Cal Rx. Find a nearby location using the DHCS Find a Pharmacy page.
Alliance Care IHSS members
Members can receive a 90-day supply, including free standard delivery, for most prescription medications mailed to them through MedImpact Direct.
To find an in-network pharmacy, use MedImpact's Pharmacy Directory.
Prescriptions can be submitted electronically to MedImpact Direct Mail or faxed to 888-783-1773. For more information on MedImpact Direct Mail, call 855-873-8739.
If members need hard copies of materials, Alliance staff will mail copies or send electronic links as requested.
Telehealth
We will work with our providers to ensure that we are supporting the provision of medically necessary care. See below for required codes for telehealth services.
- Existing face-to-face codes apply when a Medi-Cal provider/clinician is billing the Alliance for video/telephonic visits. Example codes for the PCP setting: 99201-99204, 99212-99214.
- The CPT or HCPCS code(s) must be billed using:
- Place of Service Code “02.”
- Use appropriate telehealth modifiers:
- Synchronous, interactive audio and telecommunications systems: Modifier 95.
- Asynchronous store and forward telecommunications systems: Modifier GQ.
For more information, see our provider news article covering additional guidance on telehealth services.
For assistance with billing and authorization, please call Provider Services.
COVID-19 Testing and Treatment
As of Feb. 1, Medi-Cal covers the cost of at-home COVID-19 tests for members. Federal Drug Administration (FDA)-authorized, self-administered COVID-19 antigen test kits can be billed and reimbursed as a pharmacy-billed medical supply benefit. Tests must be acquired from pharmacies that are enrolled as Medi-Cal providers. At-home COVID-19 tests are covered by Medi-Cal Rx, not the Alliance.
No-cost test kits from Medi-Cal enrolled pharmacies
Alliance members will need to go to a pharmacy that is enrolled as a Medi-Cal provider. A pharmacist can write them a prescription to get a test kit at no cost. Beneficiaries are limited to eight covered tests per month. However, more tests may be covered if they are ordered or administered by a provider after an individualized clinical assessment.
Out-of-pocket expense reimbursements for test kits
More information on out-of-pocket expense reimbursements is available on the DHCS qhov vevxais.
Free tests from the federal government
Additionally, the federal government is mailing a limited amount of free at-home COVID-19 test kits per U.S. household. Every home in the U.S. is eligible. To get these tests, individuals must request them online at www.covidtests.gov.
For more information on Medi-Cal Rx coverage of over-the-counter test kits, please view the full guidance on the DHCS website.
Several therapies have received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA). Rau the latest guidance, please visit the National Institutes of Health’s (NIH) COVID-19 Treatment Guidelines page. NIH has also provided details for therapeutic management of nonhospitalized adults with COVID-19.
The distribution system is managed by the U.S. Department of Health and Human Services. The state and local counties determine where therapeutics will be distributed and which providers will distribute them.
Providers must sign up for the distribution program. Facilities that are able to operationalize COVID-19 therapeutics and would like to be considered for product allocations should contact their Medical Health Operational Area Coordinator (MHOAC).
Locate and order government-supplied treatments
Please use the resources below to locate sites that have government-supplied COVID-19 therapeutics and to learn how to order therapeutics. Note: therapies are available to specific locations only.
- COVID-19 Therapeutics Locator: type in your location and the map will populate nearby sites and the quantity/type of treatment they have in stock.
- Distribution and Ordering of Anti-SARS-CoV-2 Therapeutics
Note: Reimbursement requests for remdesivir may be submitted to the Alliance.
Member education
Please consider educating your patients about the importance of early testing and treatment for COVID-19. Here are a few key points to emphasize:
- If patients are experiencing any symptoms of COVID-19, they should not wait to seek care. It is important for those with symptoms to talk to their doctor and test for COVID-19 as soon as possible.
- In order to be effective, therapeutic treatments must be started as soon as possible after testing positive for COVID-19.
For more information on COVID-19 treatments, including product fact sheets and patient-facing communication, visit the California Department of Public Health’s COVID-19 Treatments page.
Test to Treat locations
The federal government has launched a Test to Treat program, whereby participating locations will offer COVID-19 testing and subsequent treatment prescriptions at the same site. Use the U.S. Department of Health & Human Services (HHS) Kev Nrhiav Chaw Kuaj Kom Kho Tus Kab Mob COVID-19 (Test to Treat) to find participating Test to Treat program sites by address or zip code.
As our members continue to be affected by the COVID-19 pandemic, you are likely busy screening patients and prescribing COVID-19 laboratory testing. We want you to know that the Alliance covers both laboratory testing and screening for COVID-19.
To ensure you receive appropriate reimbursement, you must submit COVID-19 related claims using the following procedure codes:
Code | Description |
U0001 | 2019-Novel Coronavirus [2019-nCoV diagnostic p] |
U0002 | COVID-19 lab test non-CDC |
87635 | SARS-COV-2 COVID-19 AMP PRB |
For a list of contracted labs, providers may reference the Alliance Phau Ntawv Teev Cov Kws Kho Mob or contact their Provider Relations Representative.
Provider Support
We understand that providers are extremely busy as they focus on providing patient care. In order to support our providers in prioritizing member access to care and to follow public health guidelines, we have suspended in-person provider visits. All interactions and provider follow-up discussions will occur by webinar, phone and email. We will focus on supporting our providers in the most efficient way possible during this time.
Yes, we are maintaining business operations. Our mission is to ensure our members in Merced, Monterey and Santa Cruz counties continue to access needed health care.
The Alliance will continue to follow public health guidelines to slow the spread of COVID-19 and ensure the health and safety of our members, staff and visitors. We will provide up-to-date information about in person visits to our offices on our website and through direct provider communications.
We continue to monitor the situation by staying in touch with public health and government officials, and we are following their guidance as the situation continues to evolve.
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This chart provides guidance on which COVID-19 vaccine is recommended for a patient, based on age or health conditions.
Telehealth Awareness
- Provider Newsletter - Issue 8: Guidance on well-child visits via telehealth.
- Provider Newsletter - Issue 5: Information on eConsults and virtual visits.
- Provider Newsletter - Issue 2: Includes information on telephonic visits, video visits and required codes for telehealth services.
- Provider Newsletter - Issue 1: See “New telehealth guidance.”
- Suicide Prevention Tips for Health Care Providers
- Taking Care of Your Behavioral Health: Tips for social distancing, quarantine, and isolation during an infectious outbreak
- Emotional Wellness Toolkit
- Coping with stress during infectious disease outbreaks
- SAMHSA's Disaster Distress Helpline: The toll-free number is 800-985-5990 (English and Spanish).
- Criteria for admission to Stanford's LPCH Eating Disorders Program
- DHCS APL 20-022 – COVID 19 Vaccine Administration includes information about:
- New DHCS requirements for visitors in acute health care and long-term care settings.
- The health care worker vaccine requirement.
- CDC COVID-19 One-Stop Shop Toolkits: includes resources for communicating COVID-19 information for various audiences and demographics.
Contact Provider Services
General | 831-430-5504 |
Cov Kev Thov Billing questions, claims status, general claims information |
831-430-5503 |
Authorizations General authorization information or questions |
831-430-5506 |
Authorization Status Checking the status of submitted authorizations |
831-430-5511 |
Lub Tsev Muag Tshuaj Authorizations, general pharmacy information or questions |
831-430-5507 |
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