​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​2023 Approved State Plan Amendments

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​The following attachments ​are amendments to the California State Plan that were recently approved by the Centers for Medicare and Medicaid Services (CMS). Stakeholders can update their copies by following the links and instructions attached to the documents.​​​

• ​23-0001​ Updates the Current Dental Terminology (CDT) code set to CDT-23. 
  
• 23-0003 Updates the reimbursement methodology for Durable Medical Equipment.
  
• 23-0005​​ ​Updates existing language to reflect the CDSS updated IHSS policy to allow telehealth reassessments and to update existing language to reflect CDSS IHSS QA updated practices. 
  
• 23-0006​ Renew and modify the existing facility-specific reimbursement methodology for Freestanding Skilled Nursing Facility Level-B (FS/NF-B) and Freestanding Subacute (FSSA) facilities. 
  
• 23-0007 Provides supplemental payments for private hospital inpatient services for the service period of January 1, 2023 to December 31, 2024.
• 23-0008​ Provides​ supplemental payments for private hospital outpatient services for the service period of January 1, 2023 to December 31, 2024.
• 23-0009​ Extends Medi-Cal eligibility to foster youth from any state who turned 18 years of age on or after January 1, 2023 so long as they otherwise meet the eligibility requirements of being under age 26, enrolled in Medicaid and exiting foster care at age 18 or older. ​​
  
• 23-0012​ Disregards, under the authority of section 1902(r)(2) of the Social Security Act, all countable resources for all eligibility groups covered under the state plan to which a resource standard applies.
  
• 23-0013​ ​​Extends and modifies the Private Hospital Supplemental Fund program for the state fiscal year ending in 2024.​​
  
• 23-0014​ Updates the Medi-Cal reimbursement methodology for State Fiscal Year 2023-24 Diagnosis Related Group Payments. ​
  
• 23-0015​ Modifies the reimbursement methodology for Medi-Cal behavioral health services. ​
  
• 23-0016​ Extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2024. 
  
• 23-0017​ Reduces the payment cap for supplemental reimbursement to Martin Luther King Jr. – Los Angeles Healthcare Corporation (MLK-LA).
  
• 23-0019​ Updates the reimbursement methodology for clinical laboratory or laboratory services. 
• 23-0020​ Authorizes supplemental add-on payments to the fee schedule rates for eligible ground emergency medical transports provided July 1, 2023 through June 30, 2024. 
• 23-0022​ Aligns services provided by Registered Dental Hygienists (RDHs), Registered Dental Hygienists in Extended Functions (RDHEFs), and Registered Dental Hygienists in Alternative Practice (RDHAPs) with the state’s scope of practice laws.​
• 23-0024 Adds Coordinated Family Supports as a new service in​ the 1915(i) State Plan.​
• 23-0025​ Clarifies the reimbursement methodology for care coordination, recovery support services, peer support specialist services, and Medication Addiction Treatment when provided in a residential treatment setting. 
• 23-0026​ Updates the Rehabilitative Mental Health Services, Targeted Case Management, Substance Use Disorder Treatment Services, Expanded Substance Use Disorder Treatment Services, Medication-Assisted Treatment, and Community-Based Mobile Crisis Intervention Services provider types and qualifications. 
• 23-0028​ Updates the rate setting methodology for freestanding pediatric subacute (FS/PSA) facilities effective July 1, 2023, and changes the FS/PSA rate year to a calendar year rate year effective January 1, 2024. 
• 23-0029​ Clarifies and updates denture policy categorical information and clarify exemptions in the prosthodontics (removable) general policies for Medi-Cal. 
• 23-0030​ Reduced Scope for Asset Verification System requirement for Non-MAGI programs.​
• 23-0032​ Shifts reimbursement for specified long-term care facilities to a calendar rate year. 
• 23-0033​ Allows facilitated enrollment of California Work Opportunity and Responsibility to Kids (CalWORKs) beneficiaries into the Medicaid program without a separate financial eligibility determination effective July 1, 2023.
• 23-0034​ Clarifies existing policy for preventive services regarding mandatory coverage requirements for approved adult vaccines to comply with CMS guidance.
• 23-0035 Authorizes reimbursement rate increases for primary care, obstetric, and non-specialty mental health services, which are ​effective for dates of service on or after January 1, 2024.​
  
• 23-0036​ Increases rates for independent living programs, adult residential homes​ and participant-directed day service and supported employment.
  
• 23-0037​ Adds Licensed Professional Clinical Counselors (LPCCs) to the list of billable practitioners providing services at Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal FQHCs. This SPA also makes a technical change to list “Clinical Psychologist” in place of "Licensed Clinical Psychologist" and "Licensed Psychologist."​
  
• 23-0043​ Reimburse providers an ingredient cost, based on a submitted invoice price, for a covered outpatient drug when other pricing benchmarks are unavailable. 
  
• 23-0044​ ​Expands​ the prescribing authority for enteral formulae from physicians to include physicians, nurse practitioners, clinical nurse specialists, or physician assistants.
  
• 23-0045​ Updates the methodology in which reimbursement for acute psychiatric inpatient hospital services for each Fee-For-Service and Short-Doyle Medi-Cal hospital is determined between the negotiating entity and the servicing hospital.