Saib daim nqi + Rx hloov tshiab, kev pab tswv cuab thiab ntau dua!
Qhia kev nkag tebchaws thiab kev saib xyuas kev noj qab haus huv rau cov tswv cuab
Lub Alliance tab tom sib koom cov kev pabcuam tshiab los pab cov tswvcuab taug kev txog kev nkag tebchaws thiab kev txhawj xeeb txog kev noj qab haus huv. Cov no suav nrog cov ntaub ntawv hais txog kev tsim nyog tau txais Medi-Cal, kev pab kev cai lij choj hauv zos thiab xeev, thiab cov kev pab txhawb nqa muaj txawm tias muaj xwm txheej nkag tebchaws. Cov ntsiab lus tseem ceeb rau cov tswv cuab:
- Kev tsim nyog Medi-Cal tseem tsis hloov pauv - txhua tus uas tsim nyog tseem tuaj yeem tau txais kev pab them nqi kho mob.
- Pib txij Lub Ib Hlis 2026, qee cov tswv cuab cov txiaj ntsig kev noj qab haus huv thiab kev nkag tau tuaj yeem hloov pauv.
- Cov tswv cuab yuav tsum tau mus ntsib lawv tus kws kho mob ntxiv rau kev saib xyuas uas xav tau.
Txhawm rau ua kom yooj yim rau cov tswv cuab nkag mus saib xyuas hauv tsev, peb txhawb ntau yam tsis raug nqi kev xaiv telehealth:
- Lawv tus kws kho mob, yog tias muaj xov tooj lossis video mus ntsib.
- Alliance Nurse Advice Line (844-971-8907).
- Rocket Doctor (844-996-3763 lossis online).
- Zócalo Health (213-855-3465 lossis online).
Tus neeg muab kev pab thov:Yog tias koj qhov kev coj ua muaj kev mus ntsib hauv xov tooj lossis video, thov ceeb toom rau koj Tus Neeg Saib Xyuas Kev Sib Raug Zoo. Peb yuav qhia tawm cov ntaub ntawv no rau cov tswv cuab uas hu mus thov ib tus kws kho mob uas muaj kev pabcuam telehealth. Rau tag nrho cov npe ntawm kev nkag tebchaws thiab kev saib xyuas kev noj qab haus huv, suav nrog cov kev pabcuam hauv nroog, mus saib nplooj ntawv Pab Kev Nkag Tebchaws ntawm Alliance lub vev xaib. Yog tias koj muaj lus nug lossis hloov kho tshiab los qhia, hu rau Tus Neeg Muab Kev Sib Raug Zoo Tus Neeg Sawv Cev ntawm 800-700-3874, ib. 5504 ib.
Tshiab webinar: Yuav ua li cas Cal-MAP muab cov kws kho mob los hais txog kev noj qab haus huv rau cov hluas
Mus koom lub webinar yav tom ntej txog CaliforniaChild and Adolescent Mental Health Access Portal(Cal-MAP) rau Hnub Thursday, Cuaj Hlis 4 thaum tav su txog 1 teev tsaus ntuj Qhov webinar no yog ib feem ntawmKev ua tiav nrog Lub Hom Phiajkev cob qhia series. Cal-MAP yog ib qho kev sib tham tsis raug nqi uas txhawb nqa kev saib xyuas thawj zaug thiab tsev kawm ntawv cov kws kho mob hauv kev xa cov kev kho mob hlwb zoo rau cov tub ntxhais hluas hnub nyoog 0–25 raws sijhawm. Hauv qhov webinar no, peb yuav muab cov ntsiab lus ntawm Cal-MAP cov kev pabcuam, suav nrog kev sib tham txog kev tshuaj xyuas, kuaj mob thiab kev kho mob los ntawm cov kws kho mob hlwb rau menyuam yaus, nrog rau cov peev txheej thiab kev qhia xa mus los ntawm cov neeg ua haujlwm muaj ntawv tso cai.
Paub meej
- Thaum: Hnub Thursday, Cuaj Hlis 4, 2025, thaum tav su txog 1 teev tsaus ntuj
- Qhov twg: Online.
- Sau npe:Sau npe online.
Cov ntsiab lus tseem ceeb
- Cal-MAP nthuav kev nkag mus rau kev kho mob hlwb rau cov hluas li cas.
- Yuav siv Cal-MAP portal li cas thiab cov kev pab cuam los txhawb cov menyuam yaus, cov hluas thiab cov tsev neeg uas cuam tshuam los ntawm ACEs, kev ntxhov siab thiab lwm yam teeb meem kev noj qab haus huv.
- Kawm txog cov kev cuam tshuam hauv chaw kho mob uas tau txheeb xyuas los ntawm cov neeg siv Cal-MAP.
- Txheeb xyuas cov peev txheej rau cov kws kho mob thiab tsev neeg raws li cov ncauj lus tshwj xeeb lossis kev txhawj xeeb txog kev puas hlwb.
Hais lus: Petra Steinbuchel, MD
Tus kws kho mob-tswj tshuaj hloov pauv kom paub, pib lub Cuaj Hlis 1, 2025
Lub Alliance tau hloov pauv rau tus kws kho mob tau txais txiaj ntsig tshuaj. Koj tuaj yeem nrhiav kev tso cai ua ntej (PA) cov txheej txheem ntawm peb lub vev xaib. Cov kev hloov pauv yog raws li nram no:
| HCPCS Code | Tshuaj | Hloov | Nyiam Tshuaj |
| j0750 ua | Emtricitabine 200Mg Thiab Tenofovir Disoproxil Fumarate 300Mg (Truvada) | Ntau qhov txwv | |
| j0751 ua | Emtricitabine 200Mg Thiab Tenofovir Alafenamide 25Mg (Descovy) | Ntau qhov txwv | |
| j3299 ua | Triamcinolone Acetonide (Xipere) | PA tshiab | Kenalog, Triesence |
| j7312 ua | Dexamethasone (Ozurdex) | Hloov kho PA Cov Cai | Kenalog, Triesence |
| j7313 ua | Fluocinolone Acetonide (Iluvien) | Hloov kho PA Cov Cai | Kenalog, Triesence |
| j7314 ua | Fluocinolone Acetonide (Yutiq) | Hloov kho PA Cov Cai | Kenalog, Triesence |
| j7311 ua | Fluocinolone Acetonide (Retisert) | Hloov kho PA Cov Cai | Kenalog, Triesence |
| j7351 ua | Bimatoprost (Durysta) | PA tshiab | Bimatoprost, Latanoprost |
| j7355 ua | Travoprost (iDose TR). | PA tshiab | Bimatoprost, Latanoprost |
| j2782 ua | Avacincaptad Pegol (Izervay) | PA tshiab | |
| j2781 ua | Pegcetacoplan (Syfovre) | PA tshiab |
Lub Alliance tau hloov kho cov cai hauv qab no hauv khw muag tshuaj. Yog xav thov ib daim qauv, thov hu rau Alliance Pharmacy Department ntawm 831-430-5507.
- 403-1114 Kev Saib Xyuas Tshuaj Txuas Ntxiv rau Cov Tswv Cuab Tshiab.
- 403-1123 Cov Tshuaj rau Kev Kho Mob ntawm Kev Sib Deev los yog Erectile Dysfunction.
- 403-1124 Cov txheej txheem rov qab tshuaj.
- 403-1126 Pharmaceutical Services Access.
- 403-1128 Lwm yam tshuaj uas tsis yog-Formulary.
- 403-1137 Cov Tshuaj Ua Ntej Pom Zoo los ntawm Alliance.
- 403-1139 Kev Tshawb Fawb Kev Siv Tshuaj Opioid.
- 403-1143 Tshuaj Xyuas Kev Siv Tshuaj.
- 403-1144 Pharmacy Provision of Family Planning Services.
- 403-1145 Pharmacy 340B Program.
- 403-1147 CCS Pharmaceuticals Policy.
- 403-1148 Mail Order Pharmacy Services.
- 403-1152 Site of Care.
- 403-1153 Botulinum Toxin rau Spasticity thiab Dystonia hauv Me Nyuam.
- 403-1155 Beyfortus (Nirsevimab).
2025-2026 Influenza season billing + coding updates
Tshuaj tiv thaiv muaj pes tsawg leeg rau xyoo 2025-26 US influenza
FDA pom zoo tias qhov kev tsim cov tshuaj tiv thaiv kab mob khaub thuas raws li qe rau xyoo 2025-2026 US influenza muaj cov hauv qab no:
- Tus kab mob A/Victoria/4897/2022 (H1N1) pdm09-zoo li tus kab mob.
- Tus kab mob A/Croatia/10136RV/2023 (H3N2)-zoo li tus kab mob.
- AB/Austria/1359417/2021 (B/Victoria lineage)-zoo li virus.
FDA pom zoo tias cov tshuaj tiv thaiv kab mob khaub thuas-los yog rov ua dua tshiab rau xyoo 2025-2026 US influenza season muaj cov hauv qab no:
- Tus kab mob A/Wisconsin/67/2022 (H1N1) pdm09-zoo li tus kab mob.
- A/District of Columbia/27/2023 (H3N2)-zoo li tus kab mob.
- AB/Austria/1359417/2021 (B/Victoria lineage)-zoo li virus.
VFC program Qhov Kev Pabcuam Vaccines for Children (VFC) yog ib qho kev pab cuam los ntawm tseemfwv qibsiab uas muab cov tshuaj tiv thaiv tsis tau them nqi rau cov menyuam yaus tsim nyog uas yuav tsis tau txhaj tshuaj tiv thaiv vim tsis muaj peev xwm them taus. Cov menyuam yaus hnub nyoog qis dua 19 xyoos tau txais kev pabcuam VFC. Cov menyuam yaus tsim nyog yog tias lawv yog ib qho ntawm cov hauv qab no:
- Medicaid tsim nyog.
- Tsis muaj pov hwm.
- Tsis muaj kev pov hwm.
- American Indian/Native American.
Thaum siv VFC Tshuag, append modifier SL rau tus lej tshuaj tiv thaiv. Hloov kho SL qhia VFC cov khoom siv thiab tsuas yog tso cai them rov qab rau kev tswj hwm tshuaj tiv thaiv.Rau Medi-Cal cov lus qhia: “Medi-Cal cov lej txhaj tshuaj tiv thaiv tus nqi them rau cov neeg tau txais kev pab tsim nyog tau txais VFC cov tshuaj tiv thaiv yuav raug them rov qab tsuas yog nyob rau hauv cov ntaub ntawv ntawm cov tshuaj tiv thaiv tsis txaus, kab mob sib kis, cov tshuaj tiv thaiv tshwj xeeb thaum muaj xwm txheej yuav tsum tau ua. VFC cov tshuaj tiv thaiv tshwj xeeb uas tus kws kho mob tsis sau npe rau hauv VFC qhov kev pab cuam tsis yog ib qho kev zam.
Yuav ua li cas them nqi
- Tsis txhob them tus lej CPT nrog SL hloov kho.
- Cov ntaub ntawv "tsis yog-VFC" hauv lub thawv 19 ntawm CMS daim ntawv thov lossis lub thawv 80 ntawm UB-04 daim ntawv thov.
- Xa daim ntawv thov mus rau CCAH (lub Alliance), Ceeb Toom: Sharlene Gianopoulos.
Txhua qhov kev thov yuav tsum raug them nqi ntawm UB-04, CMS-1500 lossis lawv qhov sib npaug hauv hluav taws xob.
| Txhua Alliance kab ntawm kev lag luam (hnub muaj txiaj ntsig Lub Cuaj Hli 1, 2025, txog rau Lub Rau Hli 30, 2026) | |||
| Siv rau cov tswv cuab txuas rau koj qhov kev coj ua, cov tswv cuab tsis sib txuas (tsis xav tau xa mus) lossis cov tswv cuab tswj hwm. | |||
| Lub npe tshuaj tiv thaiv | Kev noj tshuaj | Hnub nyoog Group | CPT Code |
| Afluria® (IIV3) | 0.5 mL PFS 10-bx * | 3 Xyoo & Laus | 90656 |
| 5 mL MDV.5 mL / dos | 3 Xyoo & Laus | 90658 | |
| Fluad® (IV) | 0.5 mL PFS 10-bx * | 65 xyoo & laus dua | 90653 |
| Fluarix® (IIV3) | 0.5 mL PFS 10-bx * | 3 Xyoo & Laus | 90656 |
| Flublok® | 0.5 mL PFS 10-bx * | 18 xyoo & laus dua | 90673 |
| Flucelvax® (CCIIV3) | 0.5 mL PFS 10-bx * | 6 hli & laus dua | 90661 |
| 5 mL MDV.25 mL/dose | 6 hli & laus dua | 90661 | |
| FluLaval® (IIV3) | 0.5 mL PFS 10-bx * | 6 hli & laus dua | 90656 |
| FluMist® (LAIV3) | 0.2 mL tshuaj tsuag 10-bx * | 2a49 xya | 90660 |
| Fluzone® (IV) | 0.5 mL PFS 10-bx * | 6 hli & laus dua | 90656 |
| 5 mL MDV.5 mL / dos | 3 Xyoo & Laus | 90658 | |
| Fluzone® High-Dose (IV) | 0.5 mL PFS 10-bx * | 65 xyoo & laus dua | 90662 |
| Cov npe txhaj tshuaj tiv thaiv kab mob | |
| Lub npe tshuaj tiv thaiv | Kev Tiv Thaiv Lub Npe nrog CVX* |
| Afluria® | Influenza, txhaj tshuaj, trivalent, pres dawb (140) |
| Influenza, txhaj tshuaj, trivalent (141) | |
| Fluad® | Influenza, txhaj, subunit, adjuvanted, pres dawb (168) |
| Fluarix® | Influenza, txhaj tshuaj, trivalent, pres dawb (140) |
| Flublok® | Influenza, recombinant, trivalent, txhaj, pres dawb (155) |
| Flucelvax® | Influenza, injectable, MDCK, pres free, trivalent (153) |
| Influenza, txhaj tshuaj, MDCK, trivalent (320) | |
| FluLaval® | Influenza, txhaj tshuaj, trivalent, pres dawb (140) |
| FluMist® | Influenza, nyob, intranasal, trivalent (111) |
| Fluzone® | Influenza, txhaj, cais tus kab mob, trivalent, pres free (140) |
| Influenza, txhaj, cais tus kab mob, trivalent (141) | |
| Fluzone® High-Dose | Influenza, txhaj tshuaj, koob tshuaj sib faib kab mob siab, pres dawb (135) |
* Kho CVX code rau npe txhaj tshuaj tiv thaiv yog xav tau rau Care Based Incentives (CBI).
Cov neeg mob/cov niam txiv yuav tsum tsis txhob "tshem tawm" ntawm kev sib koom npe txhaj tshuaj tiv thaiv cov ntaub ntawv tshuaj tiv thaiv kom muaj. Tus neeg mob/niam txiv tuaj yeem thov kom hloov pauv lawv cov xwm txheej sib koom txhua lub sijhawm thiab hloov kho los ntawm kev sau npe lub vev xaib.
Yog xav paub ntxiv, thov saib cov ntaub ntawv qhia tawm ntawm cov vev xaib sau npe.
