​​​​2019 Approved State Plan Amendments

• 19-0001 Provides Health Homes Program (HHP) services for members with physical health/substance use disorder chronic conditions for Group 3 counties.
• 19-0002 Provide HHP services for members with serious mental illness or serious emotional disturbance in Riverside and San Bernardino Counties.
• 19-0003 Sets the reimbursement rates for radiology services at no more than 80 percent of the corresponding Medicare 2019 Physician Fee Schedule rates.
• 19-0004 Updates the reimbursement methodology of the §1915(i) State Plan Home and Community-Based Services benefit to implement a one-year rate increase for Community-Based Day programs, Community Care Facilities under the Alternative Residential Model, and In-Home Respite agency providers in high cost counties.​
• 19-0005 (Updated August 10, 2020) Adjusts the Medi-Cal FFS reimbursement rates for Durable Medical Equipment (DME) services using the Medicare rural fee schedule for DME, Prosthetics, Orthotics, and Supplies (Technical Correction Letter​)
• 19-0007 Adds licensed professional clinical counselors and associate professional clinical counselors as providers of Medi-Cal psychology services.
• 19-0008 Modifies the current Medi-Cal Net Cost Supplemental Drug Rebate Agreement template.
• 19-0011 Updates the effective date for clinical laboratory service rates with a new fee schedule beginning April 1, 2019.
• 19-0012 Extends augmentation payments to emergency medical air transportation providers for services rendered during State Fiscal Year (SFY) 2019-20 and corrects clerical errors for SFY 2017-18.
• 19-0013 Adds the Health Homes Group 3 Counties for the SMI/SED population criteria.
  
• ​19-0015​ Modifies the Medi-Cal FFS reimbursement methodology for blood factors. 
  
• 19-0017 Aligns the Alternative Benefit Plan (ABP) with the Medicaid State Plan by adding specified pharmacist services as a
  Medi-Cal benefit, which was originally approved on December 15, 2023.
  
• 19-0018 Provides supplemental payments for hospital inpatient services up to the aggregate upper payment limit.
• 19-0019 Provides supplemental payments for hospital outpatient services up to the aggregate upper payment limit.
• 19-0020 Continues the Quality Assurance Fee program and reimbursement add-on for Ground Emergency Medical Transports provided by emergency medical transport providers to Medi-Cal patients from July 1, 2019 through June 30, 2020.
• 19-0021 Extends the Proposition 56 (Prop. 56)-funded time-limited supplemental payment program for certain physician services from July 1, 2019 through December 31, 2021.
• 19-0022 Extends the Proposition 56-funded time-limited supplemental payment for intermediate care facilities for individuals with intellectual disabilities from August 1, 2019 to December 31, 2021.
• 19-0023 Updates the Private Hospital Supplemental Fund Program inpatient hospital supplement payments for the program year from July 1, 2019 to June 30, 2020.
• 19-0024 Provides that Non-Designated Public Hospital Supplemental Fund Program inpatient hospital supplemental payments will continue to be made to eligible hospitals for one additional program year from July 1, 2019 to June 30, 2020.
• 19-0025 Updates the state's All Patient Refined Diagnosis Related Group (APR-DRG) payment parameters for state fiscal year 2019-2020.
• 19-0027 Implements the Prop. 56-funded time-limited supplemental payments for specific family planning services from July 1, 2019 through December 31, 2021.
• 19-0028 Adds clarification for services rendered and billed by allied dental professionals in alternative practice.
• 19-0030 Updates the geographic area offering Targeted Case Management (TCM) Services for the "Children Under the Age of 21" TCM group.
• 19-0031 Updates the geographic area offering TCM for the "Medically Fragile Individuals" TCM group.
• 19-0032 Updates the geographic area offering TCM for the "Individuals at Risk for Institutionalization" TCM group.
• 19-0033 Updates the geographic area offering TCM for the "Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes" TCM group.
• 19-0034 Updates the geographic area offering TCM services for the "Individuals with a Communicable Disease" TCM group.
• 19-0035 Provides a one-time supplemental payment for specified providers subject to subacute payment reductions.
• 19-0038 Extends the Prop. 56-funded time-limited supplemental payments for certain dental services from July 1, 2019 through December 31, 2021.
• 19-0037 Adds Health Homes Group 4 of Orange County for the chronic physical conditio​ns/SUD population criteria.
• 19-0039 Authorizes policy changes to the current Current Dental Terminology (CDT) 13 code set, also known as CDT-13, for the Medi-Cal dental program.
• 19-0040 Extends the Prop. 56-funded time-limited supplemental payments for Family Planning, Access, Care and Treatment (FPACT) services from July 1, 2019 through December 31, 2021. 
• 19-0041 Authorizes a time-limited payment to support ongoing developmental screenings, effective January 1, 2020, through December 31, 2021 when rendered in Federally Qualified Health Centers, Rural Health Clinics, and Indian Services Memorandum of Agreement 638 clinics.
• 19-0042 Extends the Proposition 56-funded time-limited supplemental payment for pediatric subacute facilities from August 1, 2019 to December 31, 2021.
• 19-0043 Extends the Quality and Accountability Supplemental Payment program to July 31, 2020 and revises quality measures for the 2019-20 Rate Year.
• 19-0044 Establishes a supplemental payment program for Non-Emergency Medical Transportation (NEMT) services using Proposition 56-funded time-limited supplemental payments from July 1, 2019 through December 31, 2021.
• 19-0045 Updates the administration of the Health Insurance Premium Payment Program.
• 19-0046 Restores coverage for certain optional benefits such as optometric and opticians' services, audiology services, speech therapy services, podiatric services and incontinence creams and washes, and this also removes the monthly two-visit limit for services by podiatrists.
• 19-0047​​ Aligns the ABP with the Medicaid State Plan by adding coverage for audiology/speech therapy, podiatry, optometric and optician services, and incontinence creams and washes. This SPA also removes the two-visit limit for podiatrist services.
  
• 19-0048 A authorizes time-limited payments to support trauma screenings for children and adults, effective January 1, 2020, through December 31, 2021.
• 19-0049​ Adds provisions to page 74e of Section 4.26 of California’s Medicaid State Plan in compliance with new requirements set forth in Section 1004 of the federal Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act).
• 19-0050 Increases the income disregard of all countable income above 100% up to 138% of the Federal Poverty Level for the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program.

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