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​​​​​​​Notices of Proposed Changes to Medi-Cal Program

Responses to questions about proposed State Plan Amendments and Waivers are developed at the time of submission; subsequent policy changes may impact these responses.  Please contact DHCS for updates.​

Public Health Emergency Proposals Related to COVID-19

​Tribal/Designee Notifications
​Title​Release D​ate
​Demonstration Amendment Under Section 1115 of the Social Security Act ​Request for Section 1115 Demonstration Authority Related to the COVID-19 Public Health Emergency
​04/13/20
​SPA 20-0024 ​Medicaid Disaster Relief for the COVID-19 National Emergency ​04/17/20
​SPA 20-0006 (Addendum​)
 ​​Expansion of Medi-Cal Beneficiary Access to Substance Use Disorder Services 05/27/20
​Demonstration Amendment Under Section 1115 of the Social Security Act​Request for Section 1115 Demonstration Authority Related to the COVID-19 Public Health Emergency - Vaccine Distribution​12/21/20
​SPA 20-0040​Medicaid Disaster Relief for the COVID-19 National Emergency - Vaccine Administration Fee​12/21/20
​Demonstration Amendment Under Section 1115 of the Social Security Act​Request for Section 1115 Demonstration Authority Related to COVID-19 Testing in Schools​01/04/21
​SPA 20-0046 ​Reimbursement for COVID-19 testing-only encounters for Medi-Cal children in Transitional Kindergarten (TK) to 12th grade ​01/04/21
​​SPA 22-0004​

 ​Coverage for COVID-19 tests, counseling-only visits for COVID-19 vaccines for children and adults, counseling-only visits for non-COVID 19 pediatric vaccines, and reimbursement for eligible pharmacies administering COVID-19 tests.​
​01/28/22

Update to the Statewide Transition Plan

​Tribal/Designee Notifications ​Title ​Release Date
​Statewide Transition Plan Notice​
​An update to the Home and Community Based Settings (HCBS) Statewide Transition Plan
​10/10/2022
​Revised Statewide Transition Plan

​An update to the Home and Community Based Settings (HCBS) Statewide Transition Plan​05/20/2021

Quarter Ending March 30, 2025​

​Tribal/Designee Notifications
​Title
​Release Date
​Public Notice​ ​
​​Proposed Rate Addition to the Drug Medi-Cal Organized Delivery System to Include Traditional Health Care Practices 
​03/20/2025
​SPA 25-0007
​Align the Alternate Benefit Plan (ABP) with the updates made by State Plan Amendments (SPA) 24-0003, 24-0031, 24-0042, 24-0052, 25-0006, 25-0009,
and 25-0014
​02/21/2025

​SPA 25-0006
​Justice-Involved (JI) Reentry Initiative services
​02/21/2025
​SPA 25-0008​ (Addendum​) ​

​Eliminates the “four walls” limitation for IHS-MOA providers and make a technical correction to update psychological assistants associates align with recent state law changes
​02/20/2025
​SPA 25-0002

​Continues​ the Public Provider Ground Emergency Medical Transportation Intergovernmental Transfer (PP-GEMT IGT) program in Calendar Year (CY) 2025​
​02/07/2025

Quarter Ending December 31, 2024

​Tribal/Designee Notifications
​Title
​Release Date
SPA 25-0009​ (previously 24-0018)
​Adds Psychological Associate Services, Removes Change of Scope Requirement When Adding Newly MFT Services & Makes a Technical Correction
​11/22/2024
​SPA 25-0014 (previously 24-0032) (Addendum​)
Adds Certified Wellness Coach ​as a New Benefit
​11/22/2024
​SPA 24-0044​

​Update the Fee Schedule for Withdrawal Management (WM) Level 1 and 2​
​10/25/2024
​SPA 24-0051

​Add Supported Employment as a covered service under the Alternative Benefit Plan (ABP) and add additional eligibility groups to the ABP​​
​10/07/2024

Quarter Ending September 30, 2024

 

​Tribal/Designee Notifications
​Title
​Release Date
​SPA 24-0037​
Expand the list of providers who can supervise Community Health Workers/Community Health Representatives
​08/23/2024
​SPA 24-0038
Technical edits to update the Alternative Benefits Plan (ABP) section of the State Plan to include recent changes to specialty mental health services
​08/23/2024
SPA 24-0042
​Expands the continuum of community-based services and evidence-based practices available through the Medi-Cal specialty behavioral health delivery systems
​08/23/2024
​SPA 24-0047
Increases the non-risk upper payment limit for
12 rural/small counties and allow DHCS to make supplemental payments for Community-Based Mobile Crisis Intervention Services to them
​08/23/2024
​SPA 24-0052
​Adds Enhanced Community Health Worker Services as a preventive service available through Medi-Cal specialty behavioral health delivery systems​​08/23/2024
​SPA 24-0045​

​Extends the time-limited supplemental payment pool for qualifying non-hospital 340B community clinics​
​08/13/2024
​SPA 24-0039
​Eliminates the alternative payment methodology (APM)
for COVID-19 vaccine-only administration visits
​08/13/2024

Quarter Ending June 30, 2024

 

​Tribal/Designee Notifications
​Title
​Release Date
​Demonstration Addendum Under Section 1115 of the Social Security Act​
Notice of Intent to Submit an Addendum to the Pending Section 1115 Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration
05/31/2024​
​SPA 24-0033​

​Alternative to the current way Federally Qualified
Health Centers (FQHC) are paid
​05/24/2024
​SPA 24-0041​

​Changes to the Rehabilitative Mental Health Services, Targeted Case Management, Substance Use Disorder Treatment Services, Expanded Substance Use Disorder Treatment Services, and Medication-Assisted Treatment Clinical Trainee provider type definition
​05/23/2024
​SPA 24-0025​

Continuation of the existing Ground Emergency Medical
Transport (GEMT) program​
​05/01/2024

Quarter Ending March 30, 2024

 

​Tribal/Designee Notifications
​Title
​Release Date
​SPA 24-0016​
​Adding community health worker (CHW) services as a covered dental benefit to the Medi-Cal Program​
​03/28/2024
​​SPA 24-0015 (Addendum)

Expansion of behavioral health services in rural, remote, and underserved areas​
​02/23/2024
​​SPA 24-0007 (Addendum​)​

​Updating the Alternative Benefit Plan (ABP) to add Psychiatric Residential Treatment Facilities (PRTFs) as settings where inpatient psychiatric services can be provided to Medi-Cal members under 21 years of age
​02/23/2024
​SPA 24-0003​

Specifying the settings where inpatient psychiatric services to beneficiaries under 21 years of age can be provided
​02/21/2024
​SPA 24-0002​

​Continuation of the Public Provider Ground Emergency Medical Transportation Intergovernmental Transfer (PP-GEMT IGT) program in Calendar Year (CY) 2024​
​02/15/2024
Demonstration Under Section 1115 of the Social Security Act​
​Notice of Intent to Submit CalAIM Section 1115 Continuous Coverage for Children Application
​01/12/2024

Quarter Ending December 31, 2023

​​​Tribal/Designee Notifications
​​Title​
​Release Date
​​SPA 23-0043
​Establishing a reimbursement option when
pricing data is unavailable for a drug​
​11/9/2023
​​SPA 23-0037 (Addendum​)

​Expansion of behavioral health services in rural, remote, and underserved areas​​11/7/2023
​SPA 23-0044

​Expansion of the prescribing authority for coverage of enteral formulae
​11/7/2023

Quarter Ending September 30, 2023

 

​​Tribal/Designee Notifications
​Title​
​Release Date
​​SPA 23-0025​

​CalAIM Behavioral Health Payment Reform - DMC 24 Hour Services Rate Setting Methodology updates
​8/28/2023
​​SPA 23-0026
​DMC, DMC-ODS, and MAT Provider Qualifications 
​8/28/2023
​​SPA 23-0031
​SPP Continuation for Non-Hospital Clinics 
​8/28/2023
​SPA 23-0035​
​MCO Tax Targeted Rate Increase
​8/28/2023
​​​SPA 23-0029​
​Denture Policy Clarification 
 
8/25/2023
​Demonstration Under Section 1115 of the Social Security Act​​ 
​Notice of Intent to Submit Section 1115 California BH-CONNECT Demonstration Application
​8/1/2023
​​Demonstration Under Section 1115 of the Social Security Act
​Notice of Intent to Submit CalAIM Section 1115 Transitional Rent Services Amendment
​8/1/2023​

Quarter Ending June 30, 2023

 

Tribal/Designee Notifications
Title
Release Date
SPA 23-0020
Continuation of the existing Ground Emergency Medical
Transport (GEMT) program
05/15/2023

Quarter Ending March 30, 2023

Tribal/Designee Notifications
 Title
​Release Date
Tribal/Designee Notifications: Demonstration Under Section 1115 of the Social Security Act​
​Notice of Intent to Submit CalRHAD Section 1115 Application
​03/16/2023
​SPA 23-0011​ (Cancelled)
​Coverage of Virtual Communication Services
​02/23/2023
​SPA 23-0015​

​Modification of the DHCS reimbursement methodology for Medi-Cal Behavioral Health services
​02/23/2023
​SPA 23-0010

​Alternate Payment Methodology for
Dyadic Services
​02/22/2023

Quarter Ending December 31, 2022

 

Tribal/Designee Notifications
Title
Release Date
​SPA 22-0014  (Addendum)
Continue certain flexibilities following the end of the COVID-19 Public Health Emergency (PHE)
​11/22/2022
​SPA 22-0051​ 

Doula services, associate marriage and family therapists (AMFTs) and associate clinical social workers (ACSWs) as covered services/benefits under the Alternative Benefit Plan (ABP)
​11/18/2022
​SPA 22-0067​​ (Addendum​)

​Continue supplemental payments for COVID-19 vaccine-only visits following the end of the Public Health Emergency (PHE)
​11/16/2022

Quarter Ending September 30, 2022

 

Tribal/Designee Notifications
Title
Release Date
​SPA 22-0002​
​Doula services as a covered benefit
​09/09/2022
​SPA 22-0062​
Expedited Notice - ​Reimbursement rates for mpox (MPX) vaccine administration
​08/23/2022
​SPA 22-0043​
Community-based ​mobile crisis intervention services
​08/23/2022
​CalAIM 1115 and 1915(b) Waiver MCP Model Change Amendment Tribal Notice​
​CalAIM 1115 and 1915(b) Waiver MCP Model Change Amendment
​08/12/2022
​SPA 22-0040

​Continuation of the Ground Emergency Medical Transport Program - Quality Assurance Fee​
​08/09/2022

Quarter Ending June 30, 2022

 

Tribal/Designee Notifications
Title
Release Date
SPA 22-0044
Expands the list of providers who can prescribe physical therapy
​5/18/2022
​SPA 22-0019
​Adds community health worker (CHW) services, ​asthma preventive services, and routine patient costs associated with participation in qualifying clinical trials as Medi-Cal covered benefits in the Alternative Benefit Plan (ABP) ​5/18/2022
​SPA 22-0017
Routine patient costs associated with participation in qualifying clinical trials as a covered benefit
​5/18/2022
​SPA 22-0015​

​​​​​Public Provider Ground Emergency Medical
Transportation Intergovernmental Transfer (PP-GEMT IGT) program​
​5/18/2022
​SPA 22-0003​ (Addendum​)​
​Asthma preventive services as a covered benefit 
​4/12/2022

Quarter Ending March 30, 2022

 

Tribal/Designee Notifications
Title>
Release Date
​SPA 22-0023​
​Updating references and definitions, clarifying requirements, and removing outdated information for Medi-Cal Rehabilitative Mental Health Services
​2/23/2022
​SPA 22-0024
​Revision of the definition of Peer Support Specialists
​2/23/2022
​​SPA 22-0014
 ​Expansion of the definition of a health care “visit” at Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs (THP)

​The effective date of this SPA has been changed to “one day after the COVID-19 Public Health Emergency (PHE) ends.” Please note that the PHE is currently scheduled to end on April 16, 2022.​
 ​2/23/2022
​​SPA 22-0001​ (Addendum​)
 ​Adding Community Health Worker services as a covered benefit​​​
 ​2/18/2022

Quarter Ending December 31, 2021

Tribal/Designee Notifications
Title
Release Date
​SPA 21-0069
Victim Compensation Program protection following the death of the Medi-Cal member​
​11/19/2021
SPA 22-0009​ (previously SPA 21-0010)​
Extension of Proposition 56 supplemental payments for Non-Emergency Medical Transportation (NEMT) services
​11/19/2021

Quarter Ending September 30, 2021

​Tribal/Designee Notifications
 ​Title
 ​Release Date​
​SPA 21-0063​Medication Therapy Management (MTM) in the Alternative Benefit Plan (ABP) ​8/26/2021
​SPA 21-0045Supplemental Incentive Payments to Support Developmental and Trauma Screenings​8/26/2021
​SPA 21-0051 (Addendum)Medi-Cal Rehabilitative Mental Health Services 10/20/2021
​SPA 21-0058 (Addendum)Drug Medi-Cal Organized Delivery System (DMC-ODS) expanded substance use disorder services​10/20/2021
​SPA 21-0019
​New dental benefits and Pay-for-Performance (P4P) payments for dental services​07/28/2021

Quarter Ending June 30, 2021

Tribal/Designee Notifications
 ​Title
​Release Date

​CalAIM Section 1115 Demonstration Application & Cover Letter

​CalAIM Section 1115 Demonstration Amendment and Renewal Application​06/30/2021
CalAIM Section 1915(b) Waiver Application; Cover Letter; Attachments; Appendix: Cost Effectiveness BH SMHS & DMC-ODS; Appendix: Cost Effectiveness MCMC & Dental MC 
​CalAIM Section 1915(b) Waiver Amendment and Renewal Application​06/30/2021
​SPA 21-0017​Continuation of the Ground Emergency Medical Transport Program - Quality Assurance Fee​05/26/2021
​SPA 21-0028​Adding Medication Therapy Management (MTM) as a covered service ​05/25/2021
​SPA 21-0018Termination of all active SPAs associated with
the Health Homes Program (HHP) and transition HHP enrollees to the Enhanced Care Management (ECM) benefit		​05/25/2021
​Demonstration Amendment and Renewal Under Section 1115 of the Social Security Act; Waiver Overview Under Section 1915(b) of the Social Security Act​Notice of Intent to Submit Section 1115 Demonstration Amendment and Renewal and Section 1915(b) Waiver Related to Medi-Cal authorization​04/07/2021

Quarter Ending March 30, 2021

​Tribal/Designee Notifications
 ​Title​Release Date
​SPA 21-0015​Time-limited Supplemental Payment Program for Qualifying Non-Hospital 340B Community Clinics​02/05/21

 

Quarter Ending December 31, 2020

​Tribal/Designee Notifications
​Title​Release Date
​SPA 20-0039​Pharmacy Changes​10/29/20
​SPA 20-0044

​Establishment of Tribal FQHC Provider Type

​08/26/20

Quarter Ending September 30, 2020

​Tribal/Designee Notifications
​Title​Release Date
​​​​Medi-Cal 2020 Section 1115 Waiver & 1915(b) Specialty Mental Health Section Waiver 12-month extension request for the Medi-Cal 2020 Section 1115 waiver and 1915(b) specialty mental health services waiver ​07/22/20
​SPAs 20-0035 and 20-0036

​Home Health Services

​08/26/20

Quarter Ending June 30, 2020

​Tribal/Designee Notifications
​Title​Release Date
​1915(b) Waiver Amendment​Medi-Cal Specialty Mental Health Services (SMHS) Section 1915(b) Waiver Amendment​03/25/20

Quarter Ending March 31, 2020

​Tribal/Designee Notifications
​Title​Release Date
​SPA 20-0007​Clarification of Services Eligible for the Time Limited Supplement Payment Program of Non-Emergency Medical Transportation​02/18/20
​SPA 20-0009 Continuation of the Ground Emergency Medical Transport Program - Quality Assurance Fee ​02/18/20

 

Quarter Ending December 31, 2019

​Tribal/Designee Notifications​​​
​Title​Release Date
​​SPA 19-0049​​SUPPORT Act DUR Requirements ​11/14/19

 

Quarter Ending September 30, 2019

​Tribal/Designee Notifications
​Title
​Release Date
​SPAs 19-0013 and 19-0037
​Health Homes Program
​7/26/19
​SPA 1​9-0044
​Time Limited Supplement Payment Program for Non-Emergency Medical Transportation
​​8/9/19
SPA 19-0014​Expansion of Medi-Cal Beneficiary Access to Substance Use Disorder Services​8/26/19
SPA 19-0041
​Time-limited Supplemental Payment Program to Support Ongoing Developmental Screenings for Children​8/26/19
SPA 19-0046 and 19-0047​Restoration of Certain Optional Benefits for All populations in All Settings ​8/26/19
SPA 19-0048​Time-limited Supplemental Payment Program to Support Trauma Screenings for Children and Adults ​8/26/19

 

Quarter Ending June 30, 2019

Tribal Designee Notifications

​Title
Release Date​
Ground Emergency Transport Program -Quality Assurance Fee
5/22/19
​SPA 19-0017​Pharmacists Services for the New Adult Group​5/24/19

 

Quarter Ending March 31, 2019

Tribal/Designee Notifications
​Title
Release Date​
Licensed Professional Clinical Counselors (LPCCs)
​12/5/18
​SPA 19-001 & 19-002​Changes to the Health Homes Program (HHP)​1/24/19
​SPA 19-0004 & HCBS Waiver Amendment

​SPA and Waiver Amendment for Home and Community Based Services (HCBS) for Persons with Developmental Disabilities

​1/29/19

 

Quarter Ending December 31, 2018

Tribal/Designee Notifications
​Title
Release Date​
Clarification on Payment Policies for Federally Qualified Health Centers and Rural Health Clinics
​9/26/18
​SPA 18-0054​Community Crises Homes​11/5/18
​SPA 18-0040 & 18-0041​Diabetes Prevention Program (DPP)​11/20/18

 

Quarter Ending September 30, 2018

Tribal/Designee Notifications
​Title​​
Release Date​
Pharmacist Services
​6/29/18
​SPA 18-007​Supplemental Payments for Ground Emergency Medical Transportation (GEMT) Services Program
​8/8/18

 

Quarter Ending June 30, 2018

Tribal/Designee Notifications
​Title
Release Date​
Expedited Notice - Health Homes Program
​4/16/18
​SPA 18-0019 & 18-0020​Health Homes Program​5/23/18
​SPA 18-0025​Dental Rates and Periodontal Maintenance​5/25/18
​SPA 18-0027​ABP Pulmonary and Cardiac Rehabilitation​5/25/18
​SPA 18-0032

Expedited Notice - FQHC/RHC Sponsored Graduate Medical Education Program

​6/8/18

 

Quarter Ending March 31, 2018

​Tribal/Designee Notifications

​Title
Release Date​

SPA 18-002

​Proposed Changes to the Alternative Benefit Plan (ABP)

​2/23/18
SPA18-003​

​Clarifies Reimbursement Policies for Federally Qualified Health Center (FQHC) and Rural Health Clinics (RHC), and Adds Marriage and Family Therapists as a New FQHC/RHC Billable Provider

​2/22/18
​SPA 18-004​GEMT QAF​2/23/18

Additional Information

To view the current DHCS State Plan and view recently approved amendments, please visit the California State Plan webpage.​

Last modified date: 3/24/2025 2:58 PM