California Department of Healthcare Services

Drug Medi-Cal Billing

Information for counties and providers contracting with the California Department of Alcohol and Drug Programs regarding Drug Medi-Cal (DMC) billing and the submission of claims for DMC services rendered by certified DMC providers as required by California Health and Safety Code Section 11758.46(c)(1).

• Questions and Answers Regarding Billing Drug Medi-Cal for Patients Who Have Other Health Coverage
• Drug Medi-Cal (DMC) Bridge Resubmission for Phase 1 Claims
• Claims Adjustment 5035C
• Drug Medi-Cal Billing Manual (eff 03-22-10)
• Notification Letter to Field of New DMC Claims Submission Certifications and Form Requirements
• Direct Contract Provider Assignment - July 2010
• County Assignment - February 2012
• DMC Claim Submission Certification - Direct Contract Provider - ADP 100185 (form) eff 12-31-09
• DMC Claim Submission Certification - Direct Contract Provider - ADP 100185 (instructions) eff 12-31-09
• DMC Claim Submission Certification - County Contracted Provider - ADP 100186 (form) eff 12-31-09
• DMC Claim Submission Certification - County Contracted Provider - ADP 100186 (instructions) eff 12-31-09
• DMC Claim Submission Certification - County Operated Provider - ADP 100187 (form) eff 12-31-09
• DMC Claim Submission Certification - County Operated Provider - ADP 100187 (instructions) eff 12-31-09
• Updated Notification Letter to Field of Revised Good Cause Cert forms - 3-4-10
• Good Cause Certification - ADP 6065A (form) rev 3-4-10
• Good Cause Certification - ADP 6065A (instructions) rev 3-4-10
• Good Cause Certification - ADP 6065B (form) rev 3-4-10
• Good Cause Certification - ADP 6065B (instructions) rev 3-4-10
• Mulitple Billing Override Certification - ADP 7700 (form) eff 12-31-09
• Multiple Billing Override Certification - ADP 7700 (instructions) eff 12-31-09