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Aid Code Master Chart (SDMC)

The Aid Code Master Chart (SDMC) is a PDF that is regularly updated. 

​Certification Forms

• MC 1982 A: SDMC Monthly Claim for Reimbursement - Treatment Cost.pdf 
• MC 1982 B: Medi-Cal Specialty Mental Health Services Quarterly Claim for Reimbursement - Administrative Cost:
• MC 1982B-1: SMHS Claims Before 9/30/2019 (88% MCHIP).xls
• MC 1982B-2: SMHS Claims From 10/1/2019 to 12/31/2019 (76.5% MCIHP).xls
• MC 1982B-3A: SMHS Claims From 1/2020 to 2/2020 (COVID – 80.84% MCHIP)
• MC 1982B-3B: SMHS Claims From 3/1/2020 to 3/31/2020 (COVID – 80.84%MCHIP)
• MC 1982B-4: Claims After 3/31/2020 (COVID – 80.84%, 30% OA)
• MC 1982B-5: Claims After 10/1/2020 (COVID 69.34%, 30% OA)
  
• MC 1982 C: SDMC Monthly Claim for Reimbursement - Quality Assurance/Utilization Review (QA/UR) Cost.xls
• MC 1982 D: SDMC Quarterly Claim for Reimbursement - Medi-Cal Administrative Activities (MAA).xls  
• MC 1982 G: SD/MC Quarterly Claim for Reimbursement - Medi-Cal Administrative Activities (MAA).xls

County Interim Rate Table

• FY 2020-21 County Interim Rate Table.zip
• ​FY 2019-20 County Interim Rate Table.zip
  
• FY 2018-19 County Interim Rate Table.zip
  
• FY 2017-18 County Interim Rate Table.zip

EPSDT State General Fund (SGF) Payment Tables     

• FY 2010-11 EPSDT SGF County Ratios.pdf
• FY 2009-10 EPSDT SGF County Ratios.pdf
  

Katie A. Implementation

•  Katie A. Settlement Agreement Implementation homepage

Mental Health Provider Statement Information 

• Where to Download an MHP Statement.pdf 
  
• MHP Statement: A Sample.pdf                                                                                                                                           
  

References and Manuals

• Medicare Advantage Plans
• SDMC User Manual
• 837 Claim File Submission Validation (SR, TA1, 999).pdf
• ACA Information 
• Mental Health Medi-Cal Billing Manual (Rev. 10/13)​
• Mental Health Medi-Cal Billing Manual (Rev. 09/19)