Don’t forget to register: Sept. 10 Lunch and Learn
Our next behavioral health Lunch and Learn, “Comprehensive Diagnostic Evaluations: From Screening to Evaluation”, will take place Thursday, September 10, 2026, from noon to 1 p.m. Learn more and register today!
Reminder: CAHPS survey runs through September
의 일환으로 소비자 의료 서비스 제공자 및 시스템 평가(CAHPS) 프로그램(opens in new tab), the Alliance is partnering with Press Ganey to conduct the annual Clinician and Group Member Experience Survey through September. Alliance members linked to your practice may receive a request to participate in the survey, which asks about care received within the last six months.
For full details on the survey, please review the article published in the May 22 Provider Digest.
Reminder: Medi-Cal members may not be charged for completing forms
In alignment with the Department of Health Care Services (DHCS), the Alliance is reminding health care providers that pursuant to Section 123114 of the California Health & Safety (H&S) Code, health care providers may not charge patients, including Medi-Cal members, a fee for filling out forms or providing information responsive to forms that support a claim or appeal regarding eligibility for a public benefit program. This provision also extends to representatives of the Medi-Cal member requesting completion of the forms or information for the forms.
Public health benefit programs include:
- Medi-Cal program.
- In-Home Supportive Services program.
- California Work Opportunity and Responsibility to Kids (CalWORKs) program.
- Social Security Disability Insurance benefits.
- Supplemental Security Income/State Supplementary Program for the Aged, Blind and Disabled (SSI/SSP) benefits.
- Federal veterans service-connected compensation and nonservice-connected pension disability.
- CalFresh.
- Cash Assistance Program for the Aged, Blind, and Disabled Legal Immigrants.
- Government-funded housing subsidy or tenant-based housing assistance program.
자세한 내용은 다음을 방문하세요. DHCS 웹사이트.
Thank you for providing accessible, quality health care to Alliance members!
Expanded benefit for PTA and OTA services
Effective dates of service on or after September 1, 2026, the Alliance is expanding the benefit under the following HCPCS codes:
- G0151 (physical therapy in a home health or hospice setting).
- G0152 (occupational therapy in a home health or hospice setting).
The expansion allows physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) to provide covered services for Alliance Medi-Cal members when furnished in accordance with applicable supervision and billing requirements.
Requirements
- PTAs and OTAs in a private practice setting may work under general supervision of a licensed therapist.
- Claims for these services must be billed using the UB-04 claim form.
- Bill G0151/G0152 with revenue codes 0421/0431 accordingly.
- Box 56 must include the home health agency NPI.
- Box 76 must include the supervising physical therapist (PT) or OT (occupational therapist) NPI.
- Box 77 must include the rendering OTA or PTA NPI.
- Providers must ensure that appropriate documentation is maintained in the medical record, clearly supporting: the treating PTA/OTA, if applicable; supervising licensed PT/OT involvement; treatment rendered, units and dates of service; linkage to the treatment plan/plan of care; and compliance with applicable supervision requirements.
- All other billing and benefit requirements continue to apply.
Providers are responsible for ensuring claims are submitted accurately and that all services are supported by complete and timely documentation in the medical record. The Alliance reserves the right to audit and request medical records at any time to confirm billing appropriateness and compliance, and supporting supervision and assistant-level documentation must be retained and made available upon request for audit, oversight, medical review or fraud, waste and abuse (FWA) investigation.
Questions? Contact Claims Customer Service at 831-430-5503, Option 1.
Back-to-school mental health toolkit
Back-to-school transitions can increase stress for children and teens, especially those with existing mental health concerns. In the 2023 CDC Youth Risk Behavior Survey(opens in new tab), nearly 40% of high school students reported persistent sadness or hopelessness that interfered with usual activities.
Providers can help by identifying concerns that emerge or worsen during this transition, supporting families and connecting youth to appropriate services.
Start with a simple check-in
Ask about school, friendships, sleep and routines.
Use an equity lens
- Behavior may signal unmet needs. School avoidance or poor follow-through may be linked to challenges with transportation, housing, language, stigma or past negative experiences.
Equity-informed care starts by asking, “What happened, what support is missing and what would make care easier to access?”
Screen and refer
Use standardized behavioral health screening tools, such as:
- PHQ-9A (for adolescents).
- GAD-7.
- Pediatric Symptom Checklist.
- Vanderbilt ADHD Rating Scale.
- Columbia-Suicide Severity Rating Scale.
Take statements of hopelessness, self-harm or suicide seriously and promptly provide safety planning, referrals and warm handoffs.
Promote rest routines
Encourage consistent sleep, regular meals, nighttime preparation and calm after-school check-ins.
Connect with the school team
Ask about counseling and classroom supports such as a Student Study Team (SST), a 504 plan or an Individualized Education Program (IEP). With caregiver consent, help coordinate care with school staff and other providers.
자원
- Provider referrals:
- Alliance Behavioral Health Provider Referral Form
- Alliance Care Management: 800-700-3874, ext. 5512.
- [email protected]
- Mental Health in Schools – American Academy of Pediatrics
