20-849 Do Not Bill With CPT Codes 99386 and 99396 as of January 1, 2021 - Claims Will Be Denied

Date: 10/30/20

CHWP will not recoup already-paid claims

As of January 1, 2021, CPT codes 99386 and 99396 will not be paid and will be denied.

These codes are not on the Department of Health Care Services (DHCS) Medi-Cal fee schedule.

If you have already submitted reimbursement requests for these codes, claims will be processed based on the current fee schedule until January 1, 2021. However, they will be denied after January 1, 2021.

We are not requesting any reimbursement for payments already made on these two CPT codes since they are valid through December 31, 2020.

Additional Information

Providers are encouraged to access California Health & Wellness Plan’s (CHWP’s) provider portal online for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact CHWP at 1-877-658-0305.