Notices of Proposed Changes to Medi-Cal Program
Responses to questions about proposed State Plan Amendments and Waivers are developed at the time of submission; subsequent policy changes may impact these responses. Please contact DHCS for updates.
Public Health Emergency Proposals Related to COVID-19
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| Demonstration Amendment Under Section 1115 of the Social Security Act | Request for Section 1115 Demonstration Authority Related to the COVID-19 Public Health Emergency | 04/13/20 |
| SPA 20-0024 | Medicaid Disaster Relief for the COVID-19 National Emergency | 04/17/20 |
| SPA 20-0006 (Addendum) | Expansion of Medi-Cal Beneficiary Access to Substance Use Disorder Services | 05/27/20 |
| Demonstration Amendment Under Section 1115 of the Social Security Act | Request for Section 1115 Demonstration Authority Related to the COVID-19 Public Health Emergency – Vaccine Distribution | 12/21/20 |
| SPA 20-0040 | Medicaid Disaster Relief for the COVID-19 National Emergency – Vaccine Administration Fee | 12/21/20 |
| Demonstration Amendment Under Section 1115 of the Social Security Act | Request for Section 1115 Demonstration Authority Related to COVID-19 Testing in Schools | 01/04/21 |
| SPA 20-0046 | Reimbursement for COVID-19 testing-only encounters for Medi-Cal children in Transitional Kindergarten (TK) to 12th grade | 01/04/21 |
| SPA 22-0004 | Coverage for COVID-19 tests, counseling-only visits for COVID-19 vaccines for children and adults, counseling-only visits for non-COVID 19 pediatric vaccines, and reimbursement for eligible pharmacies administering COVID-19 tests. | 01/28/22 |
Update to the Statewide Transition Plan
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| Statewide Transition Plan Notice | An update to the Home and Community Based Settings (HCBS) Statewide Transition Plan | 10/10/2022 |
| Revised Statewide Transition Plan | An update to the Home and Community Based Settings (HCBS) Statewide Transition Plan | 05/20/2021 |
Quarter Ending March 31, 2026
| Tribal/Designee Notifications | Title | Release Date |
| Demonstration Under Section 1115 of the Social Security Act | Notice of Intent to Submit a Renewal of CalAIM Section 1115 Demonstration | 02/10/2026 |
Quarter Ending December 31, 2025
| Tribal/Designee Notifications | Title | Release Date |
| SPA 25-0043 and SPA 25-0044 | SPA 25-0043: Removal of Sunset Date for Medication-Assisted Treatment (MAT) Services & SPA 25-0044: Alternative Benefit Plan (ABP) Alignment SPA adding school-linked services (SLS) | 11/21/2025 |
| SPA 25-0029 (Addendum) | Coverage Change for GLP-1 for Weight Loss | 11/20/2025 |
| SPA 25-0041 | Reinstatement of Electronic Asset Verification Program (AVP) | 11/14/2025 |
Quarter Ending September 30, 2025
| Tribal/Designee Notifications | Title | Release Date |
| SPA 25-0028 | Establish Medi-Cal Fee-For-Service Fee Schedule Rates for Behavioral Health Treatment Services | 08/26/2025 |
| SPA 25-0037 | Reinstatement of Asset Limits for Non-MAGI Programs | 08/25/2025 |
| SPA 25-0030 | PP-GEMT IGT Add-on effective January 1, 2026 | 08/22/2025 |
| SPA 25-0003A | The Ground Emergency Medical Transport Quality Assurance Fee (GEMT QAF) Program for Private Providers | 08/22/2025 |
Quarter Ending June 30, 2025
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 25-0016 | Proposed change to the Department of Health Care Services’ (DHCS) Medi-Cal Program that will be submitted to the Centers for Medicare and Medicaid Services (CMS). | 05/21/2025 |
Quarter Ending March 30, 2025
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| Public Notice | Proposed Rate Addition to the Drug Medi-Cal Organized Delivery System to Include Traditional Health Care Practices | 03/20/2025 |
| SPA 25-0007 | Align the Alternate Benefit Plan (ABP) with the updates made by State Plan Amendments (SPA) 24-0003, 24-0031, 24-0042, 24-0052, 25-0006, 25-0009, and 25-0014 | 02/21/2025 |
| SPA 25-0006 | Justice-Involved (JI) Reentry Initiative services | 02/21/2025 |
| SPA 25-0008 (Addendum) | Eliminates the “four walls” limitation for IHS-MOA providers and make a technical correction to update psychological assistants associates align with recent state law changes | 02/20/2025 |
| SPA 25-0002 | Continues the Public Provider Ground Emergency Medical Transportation Intergovernmental Transfer (PP-GEMT IGT) program in Calendar Year (CY) 2025 | 02/07/2025 |
Quarter Ending December 31, 2024
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 25-0009 (previously 24-0018) | Adds Psychological Associate Services, Removes Change of Scope Requirement When Adding Newly MFT Services & Makes a Technical Correction | 11/22/2024 |
| SPA 25-0014 (previously 24-0032) (Addendum) | Adds Certified Wellness Coach as a New Benefit | 11/22/2024 |
| SPA 24-0044 | Update the Fee Schedule for Withdrawal Management (WM) Level 1 and 2 | 10/25/2024 |
| SPA 24-0051 | Add Supported Employment as a covered service under the Alternative Benefit Plan (ABP) and add additional eligibility groups to the ABP | 10/07/2024 |
Quarter Ending September 30, 2024
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 24-0037 | Expand the list of providers who can supervise Community Health Workers/Community Health Representatives | 08/23/2024 |
| SPA 24-0038 | Technical edits to update the Alternative Benefits Plan (ABP) section of the State Plan to include recent changes to specialty mental health services | 08/23/2024 |
| SPA 24-0042 | Expands the continuum of community-based services and evidence-based practices available through the Medi-Cal specialty behavioral health delivery systems | 08/23/2024 |
| SPA 24-0047 | Increases the non-risk upper payment limit for
12 rural/small counties and allow DHCS to make supplemental payments for Community-Based Mobile Crisis Intervention Services to them | 08/23/2024 |
| SPA 24-0052 | Adds Enhanced Community Health Worker Services as a preventive service available through Medi-Cal specialty behavioral health delivery systems | 08/23/2024 |
| SPA 24-0045 | Extends the time-limited supplemental payment pool for qualifying non-hospital 340B community clinics | 08/13/2024 |
| SPA 24-0039 | Eliminates the alternative payment methodology (APM)
for COVID-19 vaccine-only administration visits | 08/13/2024 |
Quarter Ending June 30, 2024
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| Demonstration Addendum Under Section 1115 of the Social Security Act | Notice of Intent to Submit an Addendum to the Pending Section 1115
Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration | 05/31/2024 |
| SPA 24-0033 | Alternative to the current way Federally Qualified
Health Centers (FQHC) are paid | 05/24/2024 |
| SPA 24-0041 | Changes to the Rehabilitative Mental Health Services, Targeted Case Management, Substance Use Disorder Treatment Services, Expanded Substance Use Disorder Treatment Services, and Medication-Assisted Treatment Clinical Trainee provider type definition | 05/23/2024 |
| SPA 24-0025 | Continuation of the existing Ground Emergency Medical
Transport (GEMT) program | 05/01/2024 |
Quarter Ending March 30, 2024
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 24-0016 | Adding community health worker (CHW) services as a covered dental benefit to the Medi-Cal Program | 03/28/2024 |
| SPA 24-0015 (Addendum) | Expansion of behavioral health services in rural, remote, and underserved areas | 02/23/2024 |
| SPA 24-0007 (Addendum) | Updating the Alternative Benefit Plan (ABP) to add Psychiatric Residential Treatment Facilities (PRTFs) as settings where inpatient psychiatric services can be provided to Medi-Cal members under 21 years of age | 02/23/2024 |
| SPA 24-0003 | Specifying the settings where inpatient psychiatric services to beneficiaries under 21 years of age can be provided | 02/21/2024 |
| SPA 24-0002 | Continuation of the Public Provider Ground Emergency Medical Transportation Intergovernmental Transfer (PP-GEMT IGT) program in Calendar Year (CY) 2024 | 02/15/2024 |
| Demonstration Under Section 1115 of the Social Security Act | Notice of Intent to Submit CalAIM Section 1115 Continuous Coverage for Children Application | 01/12/2024 |
Quarter Ending December 31, 2023
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 23-0043 | Establishing a reimbursement option when
pricing data is unavailable for a drug | 11/9/2023 |
| SPA 23-0037 (Addendum) | Expansion of behavioral health services in rural, remote, and underserved areas | 11/7/2023 |
| SPA 23-0044 | Expansion of the prescribing authority for coverage of enteral formulae | 11/7/2023 |
Quarter Ending September 30, 2023
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 23-0025 | CalAIM Behavioral Health Payment Reform – DMC 24 Hour Services Rate Setting Methodology updates | 8/28/2023 |
| SPA 23-0026 | DMC, DMC-ODS, and MAT Provider Qualifications | 8/28/2023 |
| SPA 23-0031 | SPP Continuation for Non-Hospital Clinics | 8/28/2023 |
| SPA 23-0035 | MCO Tax Targeted Rate Increase | 8/28/2023 |
| SPA 23-0029 | Denture Policy Clarification | |
| Demonstration Under Section 1115 of the Social Security Act | Notice of Intent to Submit Section 1115 California BH-CONNECT Demonstration Application | 8/1/2023 |
| Demonstration Under Section 1115 of the Social Security Act | Notice of Intent to Submit CalAIM Section 1115 Transitional Rent Services Amendment | 8/1/2023 |
Quarter Ending June 30, 2023
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 23-0020 | Continuation of the existing Ground Emergency Medical
Transport (GEMT) program | 05/15/2023 |
Quarter Ending March 30, 2023
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| Tribal/Designee Notifications: Demonstration Under Section 1115 of the Social Security Act | Notice of Intent to Submit CalRHAD Section 1115 Application | 03/16/2023 |
| SPA 23-0011 (Cancelled) | Coverage of Virtual Communication Services | 02/23/2023 |
| SPA 23-0015 | Modification of the DHCS reimbursement methodology for Medi-Cal Behavioral Health services | 02/23/2023 |
| SPA 23-0010 | Alternate Payment Methodology for
Dyadic Services | 02/22/2023 |
Quarter Ending December 31, 2022
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 22-0014 (Addendum) | Continue certain flexibilities following the end of the COVID-19 Public Health Emergency (PHE) | 11/22/2022 |
| SPA 22-0051 | Doula services, associate marriage and family therapists (AMFTs) and associate clinical social workers (ACSWs) as covered services/benefits under the Alternative Benefit Plan (ABP) | 11/18/2022 |
| SPA 22-0067 (Addendum) | Continue supplemental payments for COVID-19 vaccine-only visits following the end of the Public Health Emergency (PHE) | 11/16/2022 |
Quarter Ending September 30, 2022
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 22-0002 | Doula services as a covered benefit | 09/09/2022 |
| SPA 22-0062 | Expedited Notice – Reimbursement rates for mpox (MPX) vaccine administration | 08/23/2022 |
| SPA 22-0043 | Community-based mobile crisis intervention services | 08/23/2022 |
| CalAIM 1115 and 1915(b) Waiver MCP Model Change Amendment Tribal Notice | CalAIM 1115 and 1915(b) Waiver MCP Model Change Amendment | 08/12/2022 |
| SPA 22-0040 | Continuation of the Ground Emergency Medical Transport Program – Quality Assurance Fee | 08/09/2022 |
Quarter Ending June 30, 2022
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 22-0044 | Expands the list of providers who can prescribe physical therapy | 5/18/2022 |
| SPA 22-0019 | Adds community health worker (CHW) services, asthma preventive services, and routine patient costs associated with participation in qualifying clinical trials as Medi-Cal covered benefits in the Alternative Benefit Plan (ABP) | 5/18/2022 |
| SPA 22-0017 | Routine patient costs associated with participation in qualifying clinical trials as a covered benefit | 5/18/2022 |
| SPA 22-0015 | Public Provider Ground Emergency Medical
Transportation Intergovernmental Transfer (PP-GEMT IGT) program | 5/18/2022 |
| SPA 22-0003 (Addendum) | Asthma preventive services as a covered benefit | 4/12/2022 |
Quarter Ending March 30, 2022
| Tribal/Designee Notifications | Title> | Release Date |
|---|---|---|
| SPA 22-0023 | Updating references and definitions, clarifying requirements, and removing outdated information for Medi-Cal Rehabilitative Mental Health Services | 2/23/2022 |
| SPA 22-0024 | Revision of the definition of Peer Support Specialists Questions and Responses (02/24/2022) | 2/23/2022 |
| SPA 22-0014 | Expansion of the definition of a health care “visit” at Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs (THP) The effective date of this SPA has been changed to “one day after the COVID-19 Public Health Emergency (PHE) ends.” Please note that the PHE is currently scheduled to end on April 16, 2022. | 2/23/2022 |
| SPA 22-0001 (Addendum) | Adding Community Health Worker services as a covered benefit Questions and Responses (03/25/2022) | 2/18/2022 |
Quarter Ending December 31, 2021
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 21-0069 | Victim Compensation Program protection following the death of the Medi-Cal member | 11/19/2021 |
| SPA 22-0009 (previously SPA 21-0010) | Extension of Proposition 56 supplemental payments for Non-Emergency Medical Transportation (NEMT) services | 11/19/2021 |
Quarter Ending September 30, 2021
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 21-0063 | Medication Therapy Management (MTM) in the Alternative Benefit Plan (ABP) | 8/26/2021 |
| SPA 21-0045 | Supplemental Incentive Payments to Support Developmental and Trauma Screenings | 8/26/2021 |
| SPA 21-0051 (Addendum) | Medi-Cal Rehabilitative Mental Health Services | 10/20/2021 |
| SPA 21-0058 (Addendum) | Drug Medi-Cal Organized Delivery System (DMC-ODS) expanded substance use disorder services | 10/20/2021 |
| SPA 21-0019 | New dental benefits and Pay-for-Performance (P4P) payments for dental services | 07/28/2021 |
Quarter Ending June 30, 2021
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
CalAIM Section 1115 Demonstration Application & Cover Letter | CalAIM Section 1115 Demonstration Amendment and Renewal Application | 06/30/2021 |
| CalAIM Section 1915(b) Waiver Application;
Cover Letter;
Attachments;
Appendix: Cost Effectiveness BH SMHS & DMC-ODS;
Appendix: Cost Effectiveness MCMC & Dental MC | CalAIM Section 1915(b) Waiver Amendment and Renewal Application | 06/30/2021 |
| SPA 21-0017 | Continuation of the Ground Emergency Medical Transport Program – Quality Assurance Fee | 05/26/2021 |
| SPA 21-0028 | Adding Medication Therapy Management (MTM) as a covered service | 05/25/2021 |
| SPA 21-0018 | Termination of all active SPAs associated with the Health Homes Program (HHP) and transition HHP enrollees to the Enhanced Care Management (ECM) benefit | 05/25/2021 |
| Demonstration Amendment and Renewal Under Section 1115 of the Social Security Act; Waiver Overview Under Section 1915(b) of the Social Security Act | Notice of Intent to Submit Section 1115 Demonstration Amendment and Renewal and Section 1915(b) Waiver Related to Medi-Cal authorization | 04/07/2021 |
Quarter Ending March 30, 2021
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 21-0015 | Time-limited Supplemental Payment Program for Qualifying Non-Hospital 340B Community Clinics | 02/05/21 |
Quarter Ending December 31, 2020
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 20-0039 | Pharmacy Changes | 10/29/20 |
| SPA 20-0044 | Establishment of Tribal FQHC Provider Type Questions and Responses (08/31/2020) | 08/26/20 |
Quarter Ending September 30, 2020
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| Medi-Cal 2020 Section 1115 Waiver & 1915(b) Specialty Mental Health Section Waiver | 12-month extension request for the Medi-Cal 2020 Section 1115 waiver and 1915(b) specialty mental health services waiver | 07/22/20 |
| SPAs 20-0035 and 20-0036 | Home Health Services Questions and Responses (08/31/2020) | 08/26/20 |
Quarter Ending June 30, 2020
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| 1915(b) Waiver Amendment | Medi-Cal Specialty Mental Health Services (SMHS) Section 1915(b) Waiver Amendment | 03/25/20 |
Quarter Ending March 31, 2020
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 20-0007 | Clarification of Services Eligible for the Time Limited Supplement Payment Program of Non-Emergency Medical Transportation | 02/18/20 |
| SPA 20-0009 | Continuation of the Ground Emergency Medical Transport Program – Quality Assurance Fee | 02/18/20 |
Quarter Ending December 31, 2019
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPA 19-0049 | SUPPORT Act DUR Requirements | 11/14/19 |
Quarter Ending September 30, 2019
| Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
| SPAs 19-0013 and 19-0037 | Health Homes Program | 7/26/19 |
| SPA 19-0044 | Time Limited Supplement Payment Program for Non-Emergency Medical Transportation | 8/9/19 |
| SPA 19-0014 | Expansion of Medi-Cal Beneficiary Access to Substance Use Disorder Services | 8/26/19 |
| SPA 19-0041 | Time-limited Supplemental Payment Program to Support Ongoing Developmental Screenings for Children | 8/26/19 |
| SPA 19-0046 and 19-0047 | Restoration of Certain Optional Benefits for All populations in All Settings | 8/26/19 |
| SPA 19-0048 | Time-limited Supplemental Payment Program to Support Trauma Screenings for Children and Adults | 8/26/19 |
Quarter Ending June 30, 2019
Tribal Designee Notifications | Title | Release Date |
|---|---|---|
Ground Emergency Transport Program -Quality Assurance Fee | 5/22/19 | |
| SPA 19-0017 | Pharmacists Services for the New Adult Group | 5/24/19 |
Quarter Ending March 31, 2019
Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
Licensed Professional Clinical Counselors (LPCCs) | 12/5/18 | |
| SPA 19-001 & 19-002 | Changes to the Health Homes Program (HHP) | 1/24/19 |
| SPA 19-0004 & HCBS Waiver Amendment | SPA and Waiver Amendment for Home and Community Based Services (HCBS) for Persons with Developmental Disabilities Questions and Responses (2/20/19) | 1/29/19 |
Quarter Ending December 31, 2018
Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
Clarification on Payment Policies for Federally Qualified Health Centers and Rural Health Clinics Questions and Responses (10-4-18) | 9/26/18 | |
| SPA 18-0054 | Community Crises Homes | 11/5/18 |
| SPA 18-0040 & 18-0041 | Diabetes Prevention Program (DPP) | 11/20/18 |
Quarter Ending September 30, 2018
Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
Pharmacist Services | 6/29/18 | |
| SPA 18-007 | Supplemental Payments for Ground Emergency Medical Transportation (GEMT) Services Program | 8/8/18 |
Quarter Ending June 30, 2018
Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
Expedited Notice – Health Homes Program Questions and Responses (4/26/18) | 4/16/18 | |
| SPA 18-0019 & 18-0020 | Health Homes Program | 5/23/18 |
| SPA 18-0025 | Dental Rates and Periodontal Maintenance | 5/25/18 |
| SPA 18-0027 | ABP Pulmonary and Cardiac Rehabilitation | 5/25/18 |
| SPA 18-0032 | Expedited Notice – FQHC/RHC Sponsored Graduate Medical Education Program Questions and Responses (6/20/18) | 6/8/18 |
Quarter Ending March 31, 2018
Tribal/Designee Notifications | Title | Release Date |
|---|---|---|
Proposed Changes to the Alternative Benefit Plan (ABP) Questions and Responses (3/19/18) | 2/23/18 | |
| SPA18-003 | Clarifies Reimbursement Policies for Federally Qualified Health Center (FQHC) and Rural Health Clinics (RHC), and Adds Marriage and Family Therapists as a New FQHC/RHC Billable Provider Questions and Responses (3/19/18) | 2/22/18 |
| SPA 18-004 | GEMT QAF | 2/23/18 |
Additional Information
To view the current DHCS State Plan and view recently approved amendments, please visit the California State Plan webpage.