Effective February 1, 2024, the Department of Health Care Services (DHCS) will retire the use of Long Term Care (LTC) local service codes and the Payment Request for Long Term Care (25-1) local form. These local procedure codes will be replaced by National Uniform Billing Committee (NUBC) data elements and the UB-04 claim form or an electronic 837I claim transaction.
The Alliance will also be implementing these changes effective February 1, 2024.
LTC authorizations and claims will be converting to new codes effective Feb. 1.
LTC authorizations request coding and timeframes
- Authorizations currently approved for stays prior to the conversion do not need to resubmitted.
- Authorizations for stays beginning prior to 2/1/24 and extending beyond 2/1/24 should be requested with older codes.
- Authorizations for stays beginning 2/1/24 should be requested with the new codes.
Billing
Please use the appropriate billing codes effective for dates of service.
Provider webinars
DHCS has upcoming webinars for LTC conversion. See the DHCS training schedule.
For more information, please visit the DHCS website.
If you have billing questions, please contact the Claims Department at 831-430-5503. If you have authorizations questions, contact our Authorizations Team at 831-430-5506.
