The Medi-Cal Learning Portal provides extensive resources and a broad range of topics for all types of Providers with questions regarding billing requirements and claims processing guidelines. Resources are not limited to webinars, computer based training, and webinars. Providers also have direct access to their Regional Representative and the Small Provider Billing Unit (SPBU) through this link (By clicking on this link, you will be leaving the IEHP website) https://learn.medi-cal.ca.gov/.
Medi-Cal Learning Portal
Medi-Cal Rates and Codes
By clicking on these links, you will be leaving the IEHP website.
Medi-Cal Rates
The file lists the maximum reimbursement rates payable by the Medi-Cal program for covered procedures described in the HCPCS and CPT-4 coding system.
Resource: website
CPT Codes
This website is aimed at providing information to Providers on Medicare's National CCI edits, but will not address specific CCI edits.
Resource: website
Alpha-Numeric HCPCS Files
These files contain the Level II alpha-numeric HCPCS procedure and modifier codes, their long and short descriptions, and applicable Medicare administrative, coverage, and pricing data.
Resource: website
ZIP code To Carrier Locality File
This file is primarily intended for use by ambulance suppliers to map ZIP Codes to CMS carriers and localities. This file will also map ZIP Codes to their State and can determine whether the ZIP Code has a rural designation as determined by CMS.
Resource: website
Medicare Physician Fee Schedule
Information on services covered by the Medicare Physician Fee Schedule (MPFS).
Resource: website
IEHP Fee Schedule
Other Health Coverage (OHC)
Billing Code Guidelines
Thank you for being a valued partner in providing high quality care to your patients. Periodically, billing codes are updated by regulatory agencies. These guidelines will provide current billing codes and specifications and should be reviewed regularly as billing guidelines may change.