​​​​​​​​​​Service Authorization Request Tools

Dental Procedure Codes (CDT)
​​Medical Supply Tool
Restricted Drug and Enteral Products
Hemophilia Blood Factor Products
Service Code Groupings (SCG)
This Computes!

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 De​​ntal 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 its 11-digit Medi-Cal billing number are limited to the products listed. Review This Computes #421 for an alternative procedure for authorization of non-contracted enteral nutrition products.

Note: Contracted enteral nutrition products are code specific, not product name specific.

Hemophilia Blood Factor Products

Service Code Groupings (SCGs)

Note that though all FDA approved drugs are contained in the Service Code Groupings (excluding drugs that require specific authorization by CCS), all the drugs do not appear in the lists due to space constraints. A complete list of drugs that require specific authorization by CCS can be found on the Medi-Cal website

These code lists continue to require revisions. “This Computes!” will alert you when the code lists are updated.

Service Code Groupings - Medical

The list below is not complete and should be used as reference only; the Medi-Cal website contains the most current list of codes in the individual SCGs.

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:


Last modified date: 12/16/2019 2:52 PM