FFS2 Provider Manual

Local Mental Health Plan Medi-Cal Specialty Mental Health Services Fee-For-Service Network Provider Manual, 9th Edition
Document Name Revision Date Comments
Front Cover 09/27/22
Introduction 09/27/22
Important Phone Numbers 09/27/22
Table of Contents 09/27/22
Section I –  Purpose, principles, and goals 09/27/22
Section II-  The Provider Network

Section III- The Provider Relations Unit 09/27/22
Section IV-  Access to Services 09/27/22
Section V-  Confirmation of Medi-Cal Eligibility and Electronic Medi-Cal Beneficiary Enrollment 09/27/22
Section VI-  The Beneficiary Services Program and Requirements for Providing Medi-Cal Beneficiary Material to Clients 09/27/22
Section VII- Consents and Authorization Standards for Client Access to Health Information and Use/Disclosure of Health Information

Section VIII- Documentation Standards, Treatment Standards and Medical Necessity Criteria

Section IX-  Procedure Codes, Diagnosis Codes and Rates

01/01/23 Supersedes publication posted 09/27/2022. For more details see Provider Bulletin, 9th Edition, Issue 1- Procedure Code Updates posted on January 05, 2023.
Section X-   Quality Improvement 09/27/22
Section XI-  Financial Screening

Section XII- Claiming Information 09/27/22
Section XIII- Provider Fiscal Problem Resolution Process

Section XIV- Care Coordination between Physical Health and Mental Health Providers

Section XV- Over-Threshold and Inpatient Professional Services 09/27/22
Section XVI- Psychological Testing Services

Section XVII- Notice of Adverse Benefit Determination

Section XVIII- Medication, Pharmacy, Laboratory and Medicare Part D 09/27/22
Section XIX- Medical Transportation Services 09/27/22
Section XX- Out-of-County Services

Glossary of Terms 09/27/22
Acronyms & Abbreviations 09/27/22
Attachments, Policies, and Figures 09/27/22

Fee For Service Individual or Group Provider Landing Page