Provider Directory Requirements for Medi-Cal Fee-for-Service Providers
Effective July 1, 2025, Medi-Cal Fee-for-Service (FFS) providers must provide additional information listed below (in addition to the information already being collected through the Medi-Cal enrollment application). In accordance with the Centers for Medicare and Medicaid Services (CMS), the Department of Health Care Services (DHCS) is implementing guidance on Provider Directory requirements for FFS providers pursuant to Division H, Title V, Section 5123 of the Consolidated Appropriations Act, 2023 (CAA, 2023), and State Health Official 24-003 Letter, Section Provider Directory Data Requirements, Page 5.
Update Your Provider Directory Information Now
Non-Billing Providers
Actively enrolled individual Fee-For-Service (FFS) providers who directly render healthcare services to Medi-Cal members and
do not submit claims directly to Medi-Cal for services provided must submit the information by completing the
Provider Directory Survey. Non-billing providers include rendering, Ordering, Referring, and Providing (ORP) and Non-Physician Medical Practitioner (NMP) providers.
Provider Directory Survey(feature)
Background
CAA, 2023 mandates Medicaid, and Children's Health Insurance Program (CHIP) FFS programs and contracted Managed Care Plans publish searchable and regularly updated provider directories on a public website by July 1, 2025. The CAA, 2023 introduced new requirements for the FFS provider directory under Division H, Title V, Section 5123, titled "Requiring Accurate, Updated, and Searchable Provider Directories." These requirements add to the minimum required information in the FFS provider directory, which must be updated at least quarterly. The “Enrolled Medi-Cal FFS Providers" dataset housed on the California Health & Human Services Open Data Portal is considered the FFS provider directory.
New Policy
Effective July 1, 2025, FFS providers must provide the following information that will be included in the FFS provider directory (in addition to the data elements already being collected through the Medi-Cal enrollment application):
- Provider office phone number
- Provider website (if available)
- Whether the Provider is accepting new Medicaid patients
- Whether the Provider is accepting new CHIP patients
- Cultural and linguistic capabilities including languages (including American Sign Language) offered by the Provider or by a skilled medical interpreter who provides interpretation services at the Provider's office
- Which accommodations the Provider's office or facility has provided for individuals with physical disabilities, including offices, exam rooms, and equipment
- Whether the Provider offers Covered Services via telehealth
Quarterly Update
To ensure the accuracy of the provider directory, enrolled providers must review and update this information at least quarterly and by the end of each calendar month of January, April, July, and October.
Updates to existing provider directory information can be made at any time. If there are no changes to the provider directory information in future quarters, no action is required.
