Frequently Asked Questions, Fact Sheets, & Information Notices
The following are resources for the Drug Medi-Cal Organized Delivery System (DMC-ODS):
Frequently Asked Questions
Please visit the CalAIM Behavioral Health Initiative Frequently Asked Questions webpage for the most updated DMC-ODS FAQs.
Fact Sheets
DMC-ODS Related Information Notices
The purpose of this document is to outline key DMC‐ODS policy topics and provide a list of resources where counties and other stakeholders can seek additional information. In addition to the resources outlined below, additional information can be found in the Special Terms and Conditions and the Intergovernmental Agreement. Providers contracting with counties participating in DMC‐ODS may also be subject to additional Information Notices.
For a complete list of Mental Health and Substance Use Disorder Services (MHSUDS) Information Notices, please visit the MHSUDS Information Notices webpage.
For additional resources for counties, please visit the Resources for Counties page.
Billing and Fiscal Considerations
| No Issued |
Subject |
Date |
|---|---|---|
| 19-034 |
Overpayment Recovery and Reporting Procedures |
7/1/2019 |
| 19-032 |
Drug Medi-Cal Organized Delivery System 837 Institutional (837I) Claims for American Society of Addiction Medicine (ASAM) Level of Care 3.7 and 4.0 |
6/17/2019 |
| 19-016 |
Revisions to County-Specific Interim Rates under the Drug Medi-Cal Organized Delivery System |
3/18/2019 |
| 18-058 |
Supersedes IN 16-059. Substance Abuse Prevention and Treatment Block Grant Funded Room and Board for Transitional Housing, Recovery Residences and Residential Treatment Services | 12/17/2018 |
| 18-052 | Delay in Short-Doyle Claims Processing for Buprenorphine-Naloxone under the Drug Medi-Cal Organized Delivery System | 10/25/2018 |
| 18-037 | MHSUDS Drug Medi-Cal Reimbursement Rates for Fiscal Year 2018-19 | 8/3/2018 |
| 18-036 | Medication Assisted Treatment Reimbursement Rates for Fiscal Year 2018-19 Under the Drug Medi-Cal Organized Delivery System | 8/3/2018 |
| 18-023 | Drug Medi-Cal Organized Delivery System Cost Reporting Requirements for Narcotic Treatment Programs |
5/25/2018 |
| 17-047 | Substance Abuse Prevention and Treatment Block Grant Coverage Gaps in Drug Medi-Cal and Drug Medi-Cal Organized Delivery System Waiver Substance Use Disorder Services | 9/20/2017 |
| 17-039 | Supersedes IN 17-023: Changing Same Day Billing Requirements for Counties that Opt-In to the Drug Medi-Cal (DMC) Organized Delivery System (ODS) 1115 Demonstration Waiver | 8/18/2017 |
| 17-030 | State Health Information Guidance (SHIG) for Sharing Behavioral Health Information in California | 6/26/2017 |
| 17-029 | Medication Assisted Treatment Reimbursement Rates for Fiscal Year 2017-18 Under the Drug Medi-Cal Organized Delivery System | 6/26/2017 |
| 17-020 | Short-Doyle Medi-Cal (SD/MC) Claim Adjustment Reason Code and Remittance Advice Remark Code for the Drug Medi-Cal Organized Delivery System | 5/26/2017 |
| 17-011 | Reimbursement for Drug Medi-Cal Organized Delivery System Quality Assurance and Utilization Review Expenses | 4/14/2017 |
| 16-050 | Drug Medi-Cal Organized Delivery System Waiver County Implementation Fiscal Plan Guide | 10/4/2016 |
| 16-035 | Drug Medi-Cal Organized Delivery System Healthcare Common Procedure Coding System (HCPCS) and Modifiers | 7/20/2016 |
| 16-009 | State General Fund Quarterly Claiming Process for Drug Medi-Cal Organized Delivery System Participating Counties | 3/17/2016 |
| 15-034 | Drug Medi-Cal Organized Delivery System Pilot Fiscal Provisions | 8/20/2015 |
Quality Management
| No Issued |
Subject |
Date |
|---|---|---|
| 19-024 | Federal Out of Network Requirements for Drug Medi-Cal Organized Delivery System (DMC-ODS) Pilot Counties | 5/8/2019 |
| 18-051 | Drug Medi-Cal Organized Delivery System Transition of Care Policy | 10/25/2018 |
| 18-032 |
Drug Medi-Cal Organized Delivery System Treatment Perceptions Survey for Youth |
7/25/2018 |
| 18-020 | Federal Provider Directory Requirements for Mental Health Plans (MHPs) and Drug Medi-Cal Organized Delivery System (DMC-ODS) Pilot Counties | 4/24/2018 |
| 18-019 | Provider Credentialing and Re-Credentialing for Mental Health Plans (MHPs) and Drug Medi-Cal Organized Delivery System (DMC-ODS) Pilot Counties | 4/24/2018 |
| 18-010E |
Federal Grievance and Appeal System Requirements with Revised Beneficiary Notice Templates Enclosure 1 Notice of Grievance Resolution (NGR) Enclosure 2 Denial Notice (NOABD) Enclosure 3 Payment Denial Notice (NOABD) Enclosure 4 Delivery System Notice (NOABD) Enclosure 5 Modification Notice (NOABD) Enclosure 6 Termination Notice (NOABD) Enclosure 7 Timely Access Notice (NOABD) Enclosure 8 Financial Liability Notice (NOABD) Enclosure 9 NOABD Your Rights Attachment Enclosure 10 Adverse Benefit Determination Upheld (NAR) Enclosure 11 NAR Your Rights Attachment Enclosure 12 Adverse Benefit Determination Overturned (NAR) Enclosure 13 Beneficiary Non-Discrimination Notice Enclosure 14 Language Assistance Taglines Enclosure 15 Authorization Delay Notice Enclosure 16 NOABD Grievance and Appeal Timely Resolution Notice |
3/27/2018 |
| 17-046 | Reporting Requirements Related to Provider Preventable Conditions in DMC-ODS Pilot Counties | 9/20/2017 |
| 17-036 | Drug Medi-Cal County of Responsibility Transition | 7/28/2017 |
| 17-030 | State Health Information Guidance (SHIG) for Sharing Behavioral Health Information in California | 6/26/2017 |
| 17-026 | Drug Medi-Cal Organized Delivery System (DMC-ODS) Treatment Perceptions Survey | 6/9/2017 |
| 17-011 | Reimbursement for Drug Medi-Cal Organized Delivery System Quality Assurance and Utilization Review Expenses | 4/14/2017 |
Levels of Care
| No Issued |
Subject |
Date |
|---|---|---|
| 18-058 | Supersedes IN 16-059. Substance Abuse Prevention and Treatment Block Grant Funded Room and Board for Transitional Housing, Recovery Residences and Residential Treatment Services | 12/17/2018 |
| 18-046 | Supersedes IN 17-035. American Society of Addiction Medicine (ASAM) Level Of Care (LOC) Data Collection for Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver | 10/1/2018 |
| 18-042 | Perinatal Practice Guidelines | 9/20/2018 |
| 18-023 | Drug Medi-Cal Organized Delivery System Cost Reporting Requirements for Narcotic Treatment Programs | 5/25/2018 |
| 18-021 | Women and Perinatal Community Substance Use Disorder Provider Directory | 4/24/2018 |
| 16-063 | Substance Use Disorder (SUD) Treatment Services for Youth in California | 12/21/2016 |
| 16-037 |
Medically Monitored and Medically Managed Detoxification/Withdrawal Management and Residential Treatment Services in the DMC-ODS Pilot Program |
7/20/2016 |
| 15-048 | Addition of Withdrawal Management (Detox) Services | 10/12/2015 |
| 15-035 | American Society of Addiction Medicine (ASAM) Designation for Residential Facilities | 8/26/2015 |
| 15-033 |
Medications Used in Treatment of Substance Use Disorders in an Outpatient Setting |
8/14/2015 |