Medi-Cal 按服务收费提供商的提供商目录要求
自1 7 月、 2025 7 月起，Medi-Cal 按服务收费 (FFS) 提供商必须提供下列附加信息（除了已通过 Medi-Cal 注册申请收集的信息之外）。根据医疗保险和医疗补助服务中心 (CMS) 的规定，卫生保健服务部 (DHCS) 正在根据 2023 年综合拨款法案 (CAA, 2023) 第 V 章 H 部分第 5123 节和州卫生官员 24-003 号信函第 5 页“提供商目录数据要求”部分的规定，为 FFS 提供商实施提供商目录要求指导。
请参阅我们的常见问题解答以获取更多信息。
立即更新您的提供商目录信息
计费提供商
积极登记的按服务收费 (FFS) 提供商使用自己的提供商 (NPI) 编号为其提供的服务开具账单，必须在Medi-Cal 提供商门户中提交提供商目录信息。
非计费提供商
直接向 Medi-Cal 會員提供醫療保健服務且 不 直接向 Medi-Cal 提交所提供服務的索賠的個人付費服務 (FFS) 提供者 必須透過填寫 提供者名錄調查表 提交資訊。非计费医疗服务提供者包括提供、订购、转诊和提供 (ORP) 以及非医师医疗从业者 (NMP) 医疗服务提供者。
背景
CAA, 2023 mandates Medicaid, and Children’s Health Insurance Program (CHIP) FFS programs and contracted Managed Care Plans publish searchable and regularly updated provider directories on a public website by July 1, 2025. The CAA, 2023 introduced new requirements for the FFS provider directory under Division H, Title V, Section 5123, titled “Requiring Accurate, Updated, and Searchable Provider Directories.” These requirements add to the minimum required information in the FFS provider directory, which must be updated at least quarterly. The “Enrolled Medi-Cal FFS Providers” dataset housed on the California Health & Human Services Open Data Portal is considered the FFS provider directory.
新政策
自1 7 月、 2025 7 月起，FFS 提供商必须提供以下信息，这些信息将包含在 FFS 提供商目录中（除了已通过 Medi-Cal 注册申请收集的数据元素之外）：
- 提供商办公室电话号码
- 提供商网站（如果有）
- 医疗服务提供者是否接受新的医疗补助患者
- 医疗服务提供者是否接受新的 CHIP 患者
- Cultural and linguistic capabilities including languages (including American Sign Language) offered by the Provider or by a skilled medical interpreter who provides interpretation services at the Provider’s office
- Which accommodations the Provider’s office or facility has provided for individuals with physical disabilities, including offices, exam rooms, and equipment
- 提供商是否通过远程医疗提供承保服务
季度更新
To ensure the accuracy of the provider directory, enrolled providers must review and update this information at least quarterly and by the end of each calendar month of January, April, July, and October.
Updates to existing provider directory information can be made at any time. If there are no changes to the provider directory information in future quarters, no action is required.
常见问题
一般的
哪些提供商需要更新其目录信息？
Under Section 5123 of the Consolidated Appropriations Act, 2023 (CAA, 2023), Medicaid, and Children’s Health Insurance Program (CHIP) Fee-For-Service (FFS) programs and their contracted Managed Care Plans must publish searchable, regularly updated provider directories on a public website by July 1, 2025.
目录提供商包括但不限于医生、医院、药房、精神卫生服务提供者、物质使用障碍服务提供者、长期服务提供者以及提供商注册网页上列出的所有其他提供者。
我需要更新哪些信息？
Enrolled providers must submit the following directory information, which will be used to update the existing Medi-Cal Fee-For-Service Provider Directory: provider office phone number, provider website (if available), whether the provider is accepting new Medicaid patients, whether the provider is accepting new CHIP patients, whether the provider offers covered services via telehealth, cultural and linguistic capabilities, and accommodations the provider’s office or facility has provided for individuals with physical disabilities.
什么是收费服务提供商目录？
Medi-Cal 按服务收费提供商目录是CalHHS 开放数据门户上可公开访问的数据集。
我可以在 PAVE 中更新此信息吗？
不，PAVE 不会收集 2023 年 CAA 第 5123 节要求的额外提供商目录信息。
我必须多久更新一次我的信息？
为了确保提供商目录的准确性，注册提供商必须至少每季度审查和更新此信息，并在一月、四月、七月和十月的每个日历日结束前审查和更新此信息。可以随时更新现有的提供商目录信息。
What if I don’t have any changes to make after the first update?
如果首次提交后，您的提供商目录信息在随后的几个季度中没有更新，则无需采取进一步行动。
我在哪里更新我的提供商信息？
计费提供商必须在 Medi-Cal提供商门户中提交提供商目录信息。要访问该门户，已注册的 FFS 提供商必须首先在Medi-Cal 提供商网页上注册创建一个帐户。
非开票医疗服务提供者必须通过填写本页顶部的 "医疗服务提供者名录调查"来提交信息。
计费提供商的提供商门户
我在哪里可以更新提供商门户上的我的信息？
After logging in, navigate to “NPI Agreements and Settings” and select “Public Fee-For-Service Provider Directory.”
I cannot access my account on the Provider Portal. Who do I contact?
The Telephone Service Center (1-800-541-5555) is available 8 a.m. to 5 p.m. PT, Monday through Friday, except national holidays.
Who is authorized to make updates in the Provider Portal?
Only Organization Administrators and NPI Administrators can update provider directory information. To update user permissions, an Organization Administrator must add the user and assign permission levels. Refer to the Provider Portal User Guide: Provider Organization for a description of each available role.
For other Provider Portal related questions, please visit the Provider Portal FAQ.
非计费提供商的提供商目录调查
我可以在完成调查时保存我的进度吗？
No, the survey does not save incomplete responses. We recommend drafting responses in a separate document before entering them in the survey.
How can I edit my previous submission?
To make changes, please submit a new response using the Provider Directory Survey. The most recent response will overwrite previous submissions. Please allow one week upon submission for updates to reflect in directory.
How can I view my previous submission?
To request a copy of your response, please complete the Provider Inquiry Form.
有关 FFS 医疗服务提供者名录的任何其他问题，医疗服务提供者可通过以下方式联系医疗服务提供者注册部门 提供方查询表。