DHCS billing updates + the importance of lead testing
DHCS broadens billing requirements for medical services
In March, DHCS announced updates to the supervisory requirements, practice agreements and scope of practice changes for non-physician medical practitioners—including nurse practitioners (NPs), certified nurse midwives (CNMs) and licensed midwives (LMs) —to broaden the medical services which can be billed for by NPs, CNMs and LMs.
The Alliance is implementing changes to align with these updates with a retroactive effective date of 3/8/24. Claims do not need to be rebilled, as the Alliance will re-adjudicate denied claims with dates of service on or after 3/8/24.
If you have any questions about this update, please reach out to the Alliance Claims Department at 800-700-3874, ext. 5503.
Test your patients for lead exposure—it’s required by law!
California law requires a blood lead test for Medi-Cal members at 12 and 24 months, with a catch-up schedule at 24 months to 6 years for those who were not screened at 12 and 24 months. To report results, please see instructions on the California Department of Public Health (CDPH) Childhood Lead Poisoning Prevention Branch webpage.
Lead testing is also included in our Care-Based Incentive (CBI) program. Read more about the incentive on our tip sheet.
Read about the dangers of lead exposure in the latest edition of the Provider Bulletin.
We have a printable flyer from CDPH on guidance for lead testing, including how to avoid contamination during testing, which sample type to use and more. We also have a printable flyer on the importance of lead screening that you can provide members to encourage them to schedule screenings. The flyer is available in English, Spanish and Hmong.
Thank you for helping us provide quality care to our members!
