22378Rev1_Navigating Medi Cal And Specialty Health Programs 22378 22378Rev1 Navigating
User Manual: 22378
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Long Term Care (LTC)
LTC
25-1 claim form
AIDS Waiver Program
Community-Based Adult
Services (formerly ADHC)
Expanded Access to Primary Care (EAPC)
Home Health Agencies/Home and
Community-Based Services
Local Educational Agency (LEA)
Multipurpose Senior Services Program
OUTPATIENT
HOME & COMMUNITY
UB-04 claim form
AIDS Waiver Program
Chronic Dialysis Clinics
Clinics and Hospitals
Federally Qualified Health Centers (FQHC)
Heroin Detoxification
Hospice Care Program
Indian Health Services (IHS)
Inpatient Services
Rehabilitation Clinics
Rural Health Clinics (RHC)
INPATIENT/OUTPATIENT
INSTITUTIONAL
UB-04 claim form
Vision Care
VISION CARE
Pharmacy (PH) Supplies
Pharmacy
30-1 and 30-4 claim forms
PHARMACY
MEDICAL SERVICES
General Medicine (GM)
Obstetrics (OB)
Acupuncture
Audiology and Hearing Aids
Chiropractic
Durable Medical Equipment
and Medical Supplies (DME)
Medical Transportation
Orthotics and Prosthetics
Psychological Services
Therapies
ALLIED HEALTH
PROFESSIONAL
CMS-1500 claim form
*
*
PM160 CMS-1500 UB-04 30-1/30-4
MEDI-CAL SPECIALTY PROGRAMS
Comprehensive Perinatal
Services Program (CPSP)**
Every Woman Counts (EWC)**
Presumptive Eligibility (PE)**
OTHER SPECIALTY PROGRAMS
California Children’s Services (CCS)
Child Health and
Disability Prevention (CHDP)
Family Planning, Access, Care
and Treatment (Family PACT)**
Genetically Handicapped
Persons Program (GHPP)
SPECIALTY PROGRAMS
** Health Access Program (HAP)
Navigating Medi-Cal and Specialty Health Programs
Use this chart to help you navigate the Medi-Cal Learning
Portal (https://learn.medi-cal.ca.gov), understand the
Medi-Cal or specialty provider manual you reference for
policy and billing instructions (for example, the Allied Health
for Therapies manual) and identify the claim form you
use when billing for services rendered.
