Billing Beat

Medi-Cal Update – July 2020-Bulletin 553

August 10, 2020

Hepatitis C Screening Codes New Benefits for the PE4PW Program

Effective for dates of service on or after August 1, 2020, HCPCS code G0472 (hepatitis C antibody screening for individual at high risk and other covered indication[s]), CPT® codes 86803 (hepatitis C antibody) and 86804 (hepatitis C antibody, confirmatory test [eg, immunoblot]) are benefits for the Presumptive Eligibility for Pregnant Women (PE4PW) program.

PIK3CA Gene Analysis Added as a Medi-Cal Benefit

Effective for dates of service on or after August 1, 2020, CPT® code 81309 (PIK3CA gene analysis, targeted sequence analysis) is a Medi-Cal benefit. A Treatment Authorization Request (TAR)/System Authorization Request (SAR) is required for reimbursement.

Source: https://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/gm202007.aspx?

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