Saib cov kev hloov tshiab txog kev them nqi + Rx, kev pab rau cov tswv cuab thiab ntau ntxiv!
Kev sib qhia cov peev txheej kev nkag tebchaws thiab kev kho mob rau cov tswv cuab
Lub Alliance tab tom sib qhia cov peev txheej tshiab los pab cov tswv cuab daws teeb meem kev nkag tebchaws thiab kev kho mob. Cov no suav nrog cov ntaub ntawv hais txog kev tsim nyog tau txais Medi-Cal, kev pab cuam kev cai lij choj hauv zos thiab xeev, thiab cov kev pab cuam txhawb nqa uas muaj.
Kcov ntsiab lus rau cov tswv cuab:
- Kev tsim nyog tau txais Medi-Cal tseem tsis tau hloov pauv - txhua tus neeg uas tsim nyog tseem tuaj yeem tau txais kev pab them nqi.
- Txij lub Ib Hlis Ntuj xyoo 2026 mus, qee cov tswv cuab cov txiaj ntsig kev kho mob thiab kev nkag mus rau kev kho mob yuav hloov pauv.
- Cov tswv cuab yuav tsum mus ntsib lawv tus kws kho mob kom tau txais kev kho mob uas xav tau.
Yuav kom yooj yim dua rau cov tswv cuab kom tau txais kev saib xyuas los ntawm tsev, peb tab tom txhawb ntau yam cov kev xaiv kho mob hauv xov tooj uas tsis them nqi:
- Lawv tus kws kho mob, yog tias muaj kev sib ntsib hauv xov tooj lossis video.
- Kws Kho Mob Rocket (844-996-3763 los yog hauv online).
- Zócalo Health (213-855-3465 los yog hauv online).
Kev thov ntawm tus neeg muab kev pab:Yog tias koj lub chaw kho mob muab kev sib ntsib hauv xov tooj lossis video, thov qhia rau koj tus Neeg Sawv Cev rau Kev Sib Raug Zoo nrog Tus Kws Kho Mob. Peb yuav qhia cov ntaub ntawv no rau cov tswv cuab uas hu xov tooj thov tus kws kho mob uas muab kev pabcuam telehealth. Yog xav tau daim ntawv teev tag nrho ntawm cov peev txheej kev nkag tebchaws thiab kev kho mob, suav nrog cov kev pab cuam tshwj xeeb hauv lub nroog, mus saib nplooj ntawv Kev Pab Txog Kev Nkag Tebchaws ntawm lub vev xaib Alliance. Yog tias koj muaj lus nug lossis cov xov xwm tshiab los qhia, tiv tauj tus Neeg Sawv Cev Kev Sib Raug Zoo ntawm 800-700-3874, ib. 5504 ib.
Kev sib tham hauv online tshiab: Yuav ua li cas Cal-MAP thiaj li pab cov kws kho mob daws teeb meem kev noj qab haus huv ntawm cov hluas
Tuaj koom ib qho kev cob qhia hauv online txog California uas yuav los txog noLub Rooj Sib Tham Txog Kev Noj Qab Haus Huv ntawm Menyuam Yaus thiab Cov Hluas(Cal-MAP) rau ntawm Hnub Thursday, Cuaj Hlis 4 txij tav su mus txog 1 teev tsaus ntuj. Lub webinar no yog ib feem ntawmKev Siv Nrog Lub Hom Phiajcov kev cob qhia. Cal-MAP yog ib qho kev pab cuam sab laj pub dawb uas txhawb nqa kev kho mob thawj zaug thiab cov chaw muab kev pab hauv tsev kawm ntawv kom muab kev kho mob hlwb zoo thiab raws sijhawm rau cov tub ntxhais hluas hnub nyoog 0–25. Hauv lub rooj sib tham hauv online no, peb yuav muab ib daim ntawv qhia txog Cal-MAP cov kev pabcuam, suav nrog kev sab laj txog kev tshuaj xyuas, kev kuaj mob thiab kev kho mob los ntawm cov kws kho mob hlwb rau menyuam yaus, nrog rau cov lus qhia txog kev pab thiab kev xa mus los ntawm cov neeg ua haujlwm hauv zej zog uas tau tso cai.
Cov Ntsiab Lus
- Thaum: Hnub Thursday, Cuaj Hlis 4, 2025, txij thaum tav su txog 1 teev tsaus ntuj.
- Qhov twg: Hauv online.
- Sau npe:Sau npe online.
Cov ntsiab lus tseem ceeb
- Cal-MAP nthuav dav kev nkag mus rau kev kho mob hlwb rau cov tub ntxhais hluas li cas.
- Yuav siv Cal-MAP portal thiab cov kev pabcuam li cas los txhawb cov menyuam yaus, cov hluas thiab cov tsev neeg uas raug kev txom nyem los ntawm ACEs, kev ntxhov siab lom thiab lwm yam teeb meem kev noj qab haus huv.
- Kawm txog cov teebmeem kev kho mob uas cov neeg siv Cal-MAP tau pom.
- Txheeb xyuas cov peev txheej rau cov neeg muab kev pab thiab cov tsev neeg raws li cov ncauj lus tshwj xeeb lossis kev txhawj xeeb txog kev noj qab haus huv ntawm lub hlwb.
Tus Neeg Hais Lus: Petra Steinbuchel, MD
Cov kev hloov pauv tshuaj uas kws kho mob muab yuav tsum paub, siv tau txij li lub Cuaj Hlis 1, 2025
Lub Koom Haum tau hloov pauv cov txiaj ntsig ntawm cov tshuaj uas kws kho mob muab. Koj tuaj yeem nrhiav cov qauv kev tso cai ua ntej (PA) ntawm peb lub vev xaib.Cov kev hloov pauv yog raws li nram no:
| HCPCS Code | Tshuaj | Hloov | Cov Tshuaj Uas Nyiam Tshaj Plaws |
| J0750 | Emtricitabine 200mg thiab Tenofovir Disoproxil Fumarate 300mg (Truvada) | Kev txwv ntau ntxiv | |
| J0751 | Emtricitabine 200Mg Thiab Tenofovir Alafenamide 25Mg (Descovy) | Kev txwv ntau ntxiv | |
| J3299 | Triamcinolone Acetonide (Xipere) | Cov Qauv PA Tshiab | Kenalog, Triesence |
| J7312 | Dexamethasone (Ozurdex) | Hloov Kho Cov Qauv PA | Kenalog, Triesence |
| J7313 | Fluocinolone Acetonide (Iluvien) | Hloov Kho Cov Qauv PA | Kenalog, Triesence |
| J7314 | Fluocinolone Acetonide (Yutiq) | Hloov Kho Cov Qauv PA | Kenalog, Triesence |
| J7311 | Fluocinolone Acetonide (Retisert) | Hloov Kho Cov Qauv PA | Kenalog, Triesence |
| J7351 | Bimatoprost (Durysta) | Cov Qauv PA Tshiab | Bimatoprost, Latanoprost |
| J7355 | Travoprost (iDose TR) | Cov Qauv PA Tshiab | Bimatoprost, Latanoprost |
| J2782 | Avacincaptad Pegol (Izervay) | Cov Qauv PA Tshiab | |
| J2781 | Pegcetacoplan (Syfovre) | Cov Qauv PA Tshiab |
Lub Koom Haum tau hloov kho cov cai ntawm cov khw muag tshuaj hauv qab no. Yog xav tau daim qauv, thov hu rau Lub Chaw Haujlwm Muag Tshuaj ntawm Alliance 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 Kev Sib Deev lossis Erectile Dysfunction.
- 403-1124 Cov Txheej Txheem Rov Qab Tshuaj.
- 403-1126 Kev Nkag Mus Rau Cov Kev Pabcuam Tshuaj.
- 403-1128 Lwm Cov Tshuaj Uas Tsis Yog Cov Qauv Tshuaj.
- 403-1137 Cov Tshuaj Uas Lub Alliance Tau Pom Zoo Yav Dhau Los.
- 403-1139 Kev Tshuaj Xyuas Kev Siv Tshuaj Opioid.
- 403-1143 Kev Tshuaj Xyuas Kev Siv Tshuaj.
- 403-1144 Lub Tsev Muag Tshuaj Muab Kev Pabcuam Npaj Tsev Neeg.
- 403-1145 Kev Pab Cuam Txog Tshuaj 340B.
- 403-1147 Txoj Cai Tshuaj CCS.
- 403-1148 Cov Kev Pabcuam Muag Tshuaj Xa Ntawv.
- 403-1152 Qhov Chaw Saib Xyuas.
- 403-1153 Botulinum Toxin rau Spasticity thiab Dystonia hauv Cov Menyuam Yaus.
- 403-1155 Beyfortus (Nirsevimab).
Xyoo 2025-2026 Kev them nqi rau lub caij mob khaub thuas + kev hloov kho tshiab ntawm cov lej code
Cov tshuaj tiv thaiv kab mob rau xyoo 2025-26 hauv Tebchaws Meskas
FDA pom zoo kom cov tshuaj tiv thaiv kab mob khaub thuas uas muaj qe rau xyoo 2025-2026 hauv Tebchaws Meskas muaj cov hauv qab no:
- Ib tug kab mob zoo li A/Victoria/4897/2022 (H1N1) pdm09.
- Ib tug kab mob zoo li A/Croatia/10136RV/2023 (H3N2).
- AB/Austria/1359417/2021 (B/Victoria lineage)-zoo li tus kab mob.
FDA pom zoo kom cov tshuaj trivalent formulation ntawm cell- lossis recombinant-based influenza vaccines rau xyoo 2025-2026 hauv Tebchaws Meskas muaj cov hauv qab no:
- Ib tug kab mob zoo li A/Wisconsin/67/2022 (H1N1) pdm09.
- Ib tug kab mob zoo li A/District of Columbia/27/2023 (H3N2).
- AB/Austria/1359417/2021 (B/Victoria lineage)-zoo li tus kab mob.
VFC program Qhov kev pab cuam Vaccines for Children (VFC) yog ib qho kev pab cuam uas tau txais nyiaj los ntawm tsoomfwv uas muab cov tshuaj tiv thaiv kab mob pub dawb rau cov menyuam yaus uas tsim nyog uas tej zaum yuav tsis tau txhaj tshuaj tiv thaiv kab mob vim tsis muaj peev xwm them taus. Cov menyuam yaus hnub nyoog qis dua 19 xyoo tsim nyog rau qhov kev pab cuam 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. Tus Qauv Hloov Kho SL qhia txog cov khoom siv VFC thiab tsuas yog tso cai rau kev them rov qab rau kev txhaj tshuaj tiv thaiv kab mob. Raws li cov lus qhia ntawm Medi-Cal: "Cov lej txhaj tshuaj tiv thaiv kab mob Medi-Cal uas tau them rau cov neeg tau txais kev pab cuam VFC yuav raug them rov qab tsuas yog hauv cov ntaub ntawv sau tseg ntawm kev tsis txaus tshuaj tiv thaiv kab mob, kev sib kis kab mob, teeb meem xa tshuaj tiv thaiv kab mob lossis cov xwm txheej thaum tus neeg tau txais tsis ua raws li cov xwm txheej tshwj xeeb uas xav tau rau VFC cov tshuaj tiv thaiv kab mob tshwj xeeb. Tus kws kho mob tsis sau npe rau hauv qhov kev pab cuam VFC tsis yog qhov kev zam txim. "Txawm li cas los xij, Lub Koom Haum yuav ua qhov kev zam rau cov kws kho mob uas tsis yog VFC.
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 txoj kab lag luam ntawm Alliance (hnub siv tau txij lub Cuaj Hlis 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. | |||
| Tshuaj tiv thaiv npe | 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/koob tshuaj | 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/koob tshuaj | 6 hli & laus dua | 90661 | |
| FluLaval® (IIV3) | 0.5 mL PFS 10-bx * | 6 hli & laus dua | 90656 |
| Tshuaj FluMist® (LAIV3) | 0.2 mL tshuaj tsuag 10-bx * | 2a49 xya | 90660 |
| Fluzone® (IIV) | 0.5 mL PFS 10-bx * | 6 hli & laus dua | 90656 |
| 5 mL MDV.5 mL/koob tshuaj | 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 | |
| Tshuaj tiv thaiv npe | Kev Tiv Thaiv Lub Npe nrog CVX* |
| Afluria® | Kab mob khaub thuas, txhaj tshuaj tau, trivalent, tsis muaj tshuaj pres (140) |
| Kab mob khaub thuas, txhaj tshuaj, trivalent (141) | |
| Fluad® | Kab mob khaub thuas, txhaj tshuaj tau, subunit, adjuvanted, tsis muaj pres (168) |
| Fluarix® | Kab mob khaub thuas, txhaj tshuaj tau, trivalent, tsis muaj tshuaj pres (140) |
| Flublok® | Kab mob khaub thuas, recombinant, trivalent, txhaj tshuaj tau, tsis muaj tshuaj pres (155) |
| Flucelvax® | Kab mob khaub thuas, txhaj tshuaj tau, MDCK, tsis muaj tshuaj pres, trivalent (153) |
| Kab mob khaub thuas, tshuaj txhaj, MDCK, trivalent (320) | |
| FluLaval® | Kab mob khaub thuas, txhaj tshuaj tau, trivalent, tsis muaj tshuaj pres (140) |
| FluMist® | Kab mob khaub thuas, nyob, intranasal, trivalent (111) |
| Fluzone® | Kab mob khaub thuas, txhaj tshuaj tau, kab mob sib cais, trivalent, tsis muaj tshuaj pres (140) |
| Kab mob khaub thuas, txhaj tshuaj, kab mob sib cais, trivalent (141) | |
| Fluzone® Koob Tshuaj Siab | Kab mob khaub thuas, txhaj tshuaj tau, kab mob sib cais ntau koob tshuaj, tsis muaj tshuaj tiv thaiv (135) |
* Kho CVX code rau npe txhaj tshuaj tiv thaiv yog xav tau rau Care Based Incentives (CBI).
Cov neeg mob/niam txiv yuav tsum tsis txhob "xaiv tsis koom" kev sib qhia cov ntaub ntawv txhaj tshuaj tiv thaiv kab mob hauv daim ntawv teev npe txhaj tshuaj kom cov ntaub ntawv txhaj tshuaj muaj. Tus neeg mob/niam txiv tuaj yeem thov hloov lawv qhov xwm txheej sib qhia txhua lub sijhawm thiab hloov kho tshiab los ntawm lub vev xaib ntawm daim ntawv teev npe.
Yog xav paub ntxiv, thov saib cov ntaub ntawv qhia txog cov chaw sau npe.
