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Article 7. Payment for Services and Supplies | Midpage
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California Code of Regulations
Title 22
Division 3. Health Care Services
Subdivision 1. California Medical Assistance Program
Chapter 3. Health Care Services
Article 7. Payment for Services and Supplies
Article 7. Payment for Services and Supplies
State of California
51501
General.
51502
Billing Requirements.
51502.1
Requirements for Electronic Claims Submission.
51503
Physician Services.
51503.1
Reimbursement for Services Rendered by a Nonphysician Medical Practitioner.
51503.2
Reimbursement for Services Rendered by a Nurse Midwife, a Certified Family Nurse Practitioner, or a Certified Pediatric Nurse Practitioner.
51503.3
Reimbursement for Sign Language Interpreter Services.
51504
Comprehensive Perinatal Services.
51504.1
Reimbursement for Services Rendered by a Licensed Midwife.
51505
Other Professional Services. [Repealed]
51505.1
Podiatry Services.
51505.2
Nurse Anesthetist Services.
51505.3
Psychology Services.
51506
Dental Services.
51506.1
Maxillofacial Dental Services.
51506.2
Orthodontic Dental Services. [Repealed]
51507
Physical Therapy.
51507.1
Occupational Therapy.
51507.2
Speech Therapy and Audiology.
51507.3
Respiratory Care Practitioner.
51508
Hospital Inpatient Services Reimbursement. [Repealed]
51508.1
Extraordinary Administrative Adjustments. [Repealed]
51508.2
Definitions. [Repealed]
51508.3
Application. [Repealed]
51508.4
Review of Application. [Repealed]
51508.5
Criteria for Review. [Repealed]
51508.6
Recommendation. [Repealed]
51508.7
Action by the Director. [Repealed]
51508.8
Conditional Administrative Adjustments. [Repealed]
51508.9
Medi-Cal Hospital Payment Rate Exception. [Repealed]
51509
Hospital Outpatient Departments.
51509.1
Organized Outpatient Clinics.
51509.2
Chronic Hemodialysis Services.
51509.3
Rural Health Clinic Reimbursement. [Repealed]
51510
Nursing Facility Level A Services.
51510.1
Intermediate Care Services for the Developmentally Disabled.
51510.2
Intermediate Care Services for the Developmentally Disabled-Habilitative.
51510.3
Intermediate Care Services for the Developmentally Disabled-Nursing.
51511
Nursing Facility Level B Services.
51511.1
Special Program Services for the Mentally Disordered.
51511.2
Uniform Accounting and Cost Reporting System for Skilled Nursing Facilities and Intermediate Care Facilities.
51511.3
Transitional Inpatient Care Services Reimbursement. [Repealed]
51511.5
Nursing Facility Services--Subacute Care Reimbursement.
51511.6
Nursing Facility Services--Pediatric Subacute Care Reimbursement.
51512
Certified Outpatient Rehabilitation Centers.
51513
Pharmaceutical Services and Prescribed Drugs.
51513.1
Average Wholesale Price (AWP). [Repealed]
51513.2
Establishment of Maximum Allowable Ingredient Cost. [Repealed]
51513.3
Maximum Allowable Ingredient Cost. [Repealed]
51513.4
Maximum Allowable Cost. [Repealed]
51513.5
Estimated Acquisition Cost. [Repealed]
51513.6
Prudent Purchase of Drugs Program.
51514
Chiropractic Services.
51514.5
Acupuncture Services.
51515
Reimbursement for Prosthetic and Orthotic Appliances and Repairs. [Repealed]
51516
Reimbursement for Short-Doyle/Medi-Cal Services.
51516.1
Reimbursement Rates for Drug Medi-Cal Substance Abuse Program Services.
51517
Hearing Aids.
51518
Optometry Services.
51519
Eye Appliances.
51519.1
Dispensing Fees for Ophthalmic Appliances Supplied by a Fabricating Optical Laboratory Under an Exclusive Area Negotiated Contract.
51519.2
Reimbursement Rates for Ophthalmic Appliances Supplied by a Fabricating Optical Laboratory Under an Exclusive Area Negotiated Contract.
51520
Medical Supplies.
51520.1
Establishment of Maximum Allowable Product Cost for Medical Supplies. [Repealed]
51520.2
List of Generic Medical Supply Types. [Repealed]
51521
Durable Medical Equipment.
51522
Hearing and Speech Centers. [Repealed]
51523
Home Health Agency Services.
51524
In-Home Medical Care Waiver Services and Nursing Facility Waiver Services.
51525
Blood and Blood Derivatives.
51526
Incontinence Medical Supplies.
51527
Medical Transportation Services.
51528
Paramedic Ambulance Services. [Repealed]
51529
Pathology Services.
51531
Payment for Portable Imaging Services.
51532
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services.
51532.1
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Supplemental Services Provided by Registered Nurses, Licensed Vocational Nurses and Certified Home Health Aides.
51532.2
Early and Periodic, Screening, Diagnosis, and Treatment (EPSDT) Supplemental Services: Onsite Investigation to Detect the Source of Lead Contamination.
51532.3
EPSDT Supplemental Services Provider--Pediatric Day Health Care Facility Reimbursement.
51533
Outpatient Heroin Detoxification Services.
51534
Home and Community-Based Services. [Repealed]
51535
Leave of Absence.
51535.1
Bed Hold for Acute Hospitalization.
51535.2
Reimbursement Rates for Personal Care Services Program.
51535.5
Local Educational Agency (LEA) Services.
51535.6
Reimbursement for Directly Observed Therapy (DOT).
51535.7
Targeted Case Management Services Reimbursement.