Service Authorization Request Tools
Dental Procedure Codes (CDT)
Medical Supply Tool
Restricted Drug and Enteral Products
Hemophilia Blood Factor Products
Dental Procedure Codes (CDT)
California Children’s Services (CCS) follows Medi-Cal Dental policies and procedures including utilizing dental procedure codes. Medi-Cal Dental uses the American Dental Association’s (ADA) Current Dental Terminology (CDT) Codes. The most current CDT codes may not be in use. The following is a link to the current Medi-Cal Dental Provider Handbook. Go to Section 5:
Medical Supply Tool
Medical Supply Codes Requiring a Product Specific SAR.
Restricted Drug and Enteral Products
Restricted Drugs List in the Medi-Cal Provider Manual
Enteral Nutrition: List of Contracted Products
Below, are web links to the Medi-Cal Provider Manual’s List of Enteral Nutrition Products. Contracted product categories include: elemental/semi-elemental, metabolic, specialized, specialty infant, and standard enteral nutrition. CCS/GHPP coverage of enteral nutrition products that are billable by specific Medi-Cal 11-digit NDCs are limited to the products listed. Review Medi-Cal Rx Provider Manual for enteral nutrition policies and procedures.
Note: Contracted enteral nutrition products are code specific, not product name specific.
Hemophilia Blood Factor Products
Service Code Groupings – Medical
The following California Children’s Services Program Service Code Groupings document contains the most current list of codes in Service Code Groupings 01-12.
- California Children’s Services Program Service Code Groupings (January 2025).
Service Code Groupings – Dental
The Medi-Cal Dental website contains the most current list of codes included in the individual SCGs. Go to Section 9, Special Programs, in the Medi-Cal Dental Provider Handbook: