2020 Approved State Plan Amendments
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.
20-0001 Establishes a cost-based reimbursement methodology for Drug Medi-Cal (DMC) services rendered through providers that contract with one or more of eight specific counties in California. (ERRATA Approval Letter)
20-0002 Adds Health Homes Group 4 of Orange County for the SMI/SED population criteria, effective July 1, 2020.
20-0004 Updates the rates for Radiological services to pay no more than 80% of the corresponding Medicare Physician Fee Schedule rate, effective January 1, 2020.
20-0005 Adjusts certain Medi-Cal Fee-for-Service (FFS) reimbursement rates for Durable Medial Equipment (DME), effective January 1, 2020.
20-0007 Clarifies which Non-Emergency Medical Transportation (NEMT) procedure codes are eligible to receive a time-limited supplemental payment, effective January 1, 2020 through December 31, 2021.
20-0013 Extends the Non-Designated Public Hospital Supplemental Fund Program for the state fiscal year ending in 2021.
20-0014 Updates the Current Dental Terminology (CDT) dental code set to CDT 14 through CDT 2019, replacing the CDT 2013 code set, effective March 14, 2020.
20-0015 Updates the current dental terminology codes associated with dental services eligible for supplemental payments using Proposition 56 Fund, effective March 14, 2020.
20-0017 Extends the RAC exception from February 1, 2020 through February 1, 2022.
- 20-0020 Extends the Private Hospital Supplemental Fund program for the state fiscal year ending in 2021.
20-0024 Implements temporary policies, which are different from those policies and procedures otherwise applied under the State Plan, during the period of the COVID-19 public health emergency, effective March 1, 2020.
- 20-0025 Implements temporary policies to waive or modify certain requirements related to laboratory and x-ray services and rehabilitative services under the State Plan during the period of the COVID-19 public health emergency, effective March 1, 2020.
- 20-0027 Removes Imperial County and adds Mariposa County to the list of geographic areas offering Targeted Case Management (TCM) services for the "Children Under the Age of 21" TCM group.
- 20-0028 Removes Imperial, Los Angeles and Sacramento Counties and adds Mariposa and Placer Counties to the list of geographic areas offering TCM services for the "Medically Fragile Individuals" TCM group.
- 20-0029 Removes Humboldt, Imperial, and Sacramento Counties and adds Mariposa and Placer Counties to the list of geographic areas offering TCM services for the "Individuals at Risk of Institutionalization" TCM group.
- 20-0030 Removes Imperial County and adds Mariposa, Placer and Sacramento Counties to the list of geographic areas offering TCM services for the "Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes" TCM group.
- 20-0031 Removes Alameda, Imperial and Los Angeles Counties and adds Mariposa County to the list of geographic areas offering TCM services for the "Individuals with a Communicable Disease" TCM group.
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