Prior authorization codes
Central California Alliance for Health
Active CPT codes that appear on the extracted prior authorization list for this health plan.
| Code | Procedure / Service | Effective | Revised | Confidence | Source |
|---|---|---|---|---|---|
| 10181 | Scripps Gateway Court | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 11900 | Injection; intralesional up to 7 lesions | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 11901 | More than 7 lesions | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 12650 | False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 12651 | False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 12652 | False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 12653 | False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 12654 | False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 12655 | False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 12656 | False Claims Act (Federal – 31 U.S.C. § 3729-3733; California – C.G.C. § ): The California and Federal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 14525 | • Meets eligibility and medical necessity criteria contained in Sections (a), (c), (d) and (e) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 14526 | 1(d)(1), (3), (4) and (5); and (e) of the W&I Code (summarized in a. through e. below) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 14550 | o The individual requires CBAS services, as defined in W&I Code, Section , that are | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 1494F | CPT Code Only applicable for members 65 years of age and older without Medicare coverage | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 16000 | Initial treatment for 1st degree burns | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 16020 | Dressing and/or debridement of burns; small | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 16025 | Dressing and/or debridement of burns; medium | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 16030 | Dressing and/or debridement of burns; large | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 20201 | Washington, D.C | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 20550 | Injection; single tendon sheath or ligament | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 20610 | Arthrocentesis, aspiration or injection, major joint or bursa only | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 36400 | Venipuncture, age 3 or under | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 36405 | Scalp vein | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 36410 | Venipuncture, over age 3 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 36420 | Venipuncture, under age 1 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 36425 | Age 1 and over | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42820 | Use the following CPT codes when billing for ENT services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42821 | Use the following CPT codes when billing for ENT services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42825 | Use the following CPT codes when billing for ENT services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42826 | Use the following CPT codes when billing for ENT services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42830 | Use the following CPT codes when billing for ENT services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42831 | Use the following CPT codes when billing for ENT services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42835 | Use the following CPT codes when billing for ENT services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42836 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 42860 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 46600 | Diagnostic Anoscopy | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 51215 | 22, Section ) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 51303 | In accordance with California Civil Code, Section (k), the Alliance cannot reimburse providers for services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 51323 | Regulations, Title 22, Section . Such transportation is approved when the member has a medical | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 51348 | Comprehensive Perinatal Services Program (CPSP) – Per Title 22, Section , all contracted providers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 51351 | Targeted Case Management Services as specified in Title 22 CCR Section | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 51701 | Insertion of non-indwelling bladder catheter (e.g., straight catheterization for residual urine) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 51703 | Insertion of temporary indwelling bladder catheter, complicated (e.g., altered anatomy | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 54055 | Electrodesiccation | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 59025 | For same date of service (DOS) and same provider, replace billing code ( + ) with only | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64400 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64401 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64402 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64403 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64404 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64405 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64406 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64407 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64408 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64409 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64410 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64411 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64412 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64413 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64414 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64415 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64416 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64417 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64418 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64419 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64420 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64421 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64422 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64423 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64424 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64425 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64426 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64427 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64428 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64429 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64430 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64431 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64432 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64433 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64434 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64435 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64436 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64437 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64438 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64439 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64440 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64441 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64442 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64443 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64444 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64445 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64446 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64447 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64448 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64449 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64450 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64451 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64452 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64453 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64454 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64455 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64456 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64457 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64458 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64459 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64460 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64461 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64462 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64463 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64464 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64465 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64466 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64467 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64468 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64469 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64470 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64471 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64472 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64473 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64474 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64475 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64476 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64477 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64478 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64479 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64480 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64481 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64482 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64483 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64484 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64485 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64486 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64487 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64488 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64489 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64490 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64491 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64492 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64493 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64494 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64495 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64496 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64497 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64498 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64499 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64500 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64501 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64502 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64503 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64504 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64505 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64506 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64507 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64508 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64509 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64510 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64511 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64512 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64513 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64514 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64515 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64516 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64517 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64518 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64519 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64520 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64521 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64522 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64523 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64524 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64525 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64526 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64527 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64528 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64529 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 64530 | procedure. Providers must bill using CPT-4 codes (range ) and appropriate modifiers | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69200 | Clear outer ear canal | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69210 | Removal impacted cerumen | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69424 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69433 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69436 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69440 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69450 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 69631 | CCS review referral required for the following CPT codes: 42820, 42821, 42825, 42826, 42830, 42831, 42835, | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 72040 | Billing code: – Radiologic examination of spine (including cervical spine). No modifier (both | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 72052 | Billing code: – Complete X-ray, including oblique and flexion and/or extension studies. No modifier | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 72070 | Billing code: – Radiologic examination, spine, thoracic. No modifier (both professional and technical | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 72100 | Billing code: – Radiologic examination, spine, lumbosacral. No modifier (both professional and technical | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 72114 | Billing code: – Complete, including bending views. No modifier (both professional and technical | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 76805 | For same date of service (DOS) and same provider, replace billing code ( + ) with only | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 76818 | CPT – fetal biophysical profile (BPP), a test to measure fetal well-being | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 76819 | CPT – modified biophysical profile, combines a non-stress test and measurements of amniotic fluid | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 82270 | to rule out colorectal cancer in members between age 50 and 75. Billing code | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 83655 | mandate. It is important that every encounter is coded with the correct CPT code, ( – Blood lead test) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 90710 | CPT code | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92002 | Licensed Provider Fee | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92004 | Licensed Provider Fee | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92012 | Licensed Provider Fee | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92014 | Licensed Provider Fee | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92081 | Visual field exam | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92131 | San Diego, CA | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92250 | Retinal photography with interpretation for services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92507 | Evaluation – initial 30 minutes, plus Treatment of speech, language, voice | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92508 | Treatment of speech, language, voice | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92551 | Screening test, pure tone | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92552 | Pure tone audiometry | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92553 | Air and bone | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92555 | Speech audiometry | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92556 | Threshold and discrimination | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92557 | Basic comprehensive audiometry | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 92567 | Tympanometry (impedance testing) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93000 | Electrocardiogram | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93005 | Tracing only, without interpretation or report | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93010 | Interpretation and report only | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93015 | 93016 93017 93018 93024 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93016 | 93025 93040 93041 93042 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93017 | 93025 93040 93041 93042 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93018 | 93025 93040 93041 93042 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93024 | 93025 93040 93041 93042 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93025 | 93224 93226 93227 93228 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93040 | Rhythm ECG with report | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93041 | Rhythm ECG, tracing | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93042 | Rhythm ECG, report | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93224 | 93229 93268 93270 93271 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93226 | 93229 93268 93270 93271 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93227 | 93229 93268 93270 93271 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93228 | 93229 93268 93270 93271 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93229 | 93303 93304 93306 93307 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93268 | 93303 93304 93306 93307 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93270 | 93303 93304 93306 93307 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93271 | 93303 93304 93306 93307 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93303 | 93308 93312 93315 93318 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93304 | 93308 93312 93315 93318 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93306 | 93308 93312 93315 93318 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93307 | 93308 93312 93315 93318 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93308 | 93320 93321 93325 93350 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93312 | 93320 93321 93325 93350 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93315 | 93320 93321 93325 93350 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93318 | 93320 93321 93325 93350 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93320 | 93880 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93321 | 93880 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93325 | 93880 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93350 | 93880 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93722 | San Jose, CA Fresno, CA | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93797 | Cardiac Rehabilitation – Referral Required | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93798 | Cardiac Rehabilitation – Referral Required | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93880 | Use the following CPT codes when billing for ECG services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 93901 | Salinas, CA -4419 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 94150 | Vital capacity | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 94244 | Sacramento, CA -2430 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 94625 | Pulmonary Rehabilitation – Referral Required | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 94626 | Pulmonary Rehabilitation – Referral Required | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 94640 | Inhalation treatment | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95017 | Allergy testing, with venoms | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95018 | Allergy testing, with drugs or biological | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95023 | Hollister, CA -2814 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95052 | Photo patch tests | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95066 | Scotts Valley, CA -4981 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95067 | Scotts Valley, CA -0015 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95070 | Bronchial allergy tests | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95076 | Watsonville, CA Salinas, CA Merced, CA | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95115 | Single injection | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95117 | Multiple use allergy injections | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95119 | San Jose, CA Fresno, CA | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95199 | Unlisted allergy immunology services | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95338 | Mariposa, CA -9556 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95340 | Merced, CA -4710 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95348 | Watsonville, CA Salinas, CA Merced, CA | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 95741 | Rancho Cordova, CA -0730 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 96125 | CPT Code Time spent administering standardized cognitive performance tests to the patient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97014 | Application of a modality to 1 or more | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97110 | Therapeutic procedure, 1 or more areas, Manual therapy techniques | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97112 | Neuromuscular reeducation ( ) of Therapeutic activities direct (one on one) patient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97113 | Aquatic therapy with therapeutic exercises Self-care/home management training (e.g | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97116 | Gait Training includes stair climbing | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97124 | An initial Physical Therapy Evaluation – Massage, including effleurange, petrissage and/or | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97140 | Manual therapy techniques (e.g | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97530 | Neuromuscular reeducation ( ) of Therapeutic activities direct (one on one) patient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97535 | Self-care/home management training | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97799 | Unlisted physical medicine | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97802 | • CPT Code – MNT, initial assessment and intervention, individual, face-to-face with patient, each | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97803 | • CPT Code – MNT, re-assessment and intervention, individual, face-to-face with patient, each 15 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 97804 | • CPT Code – MNT, group (2 or more individual (s), each 30 minutes | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 98960 | Education and training for patient self-management by a qualified, nonphysician health care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 98961 | Education and training for patient self-management by a qualified, nonphysician health care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 98962 | Education and training for patient self-management by a qualified, nonphysician health care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99000 | Handling and/or conveyance of specimen for transfer from the physician’s office to a | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99070 | Special supplies | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99202 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99203 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99204 | 5. Must be billable under CPT codes or | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99205 | 5. Must be billable under CPT codes or | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99206 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99207 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99208 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99209 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99210 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99211 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99212 | 3. Must be billable under CPT codes through | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99213 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99214 | Management (E&M) service (e.g., ), not paid separately and not covered by and . For | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99215 | 3. Must be billable under CPT codes through | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99221 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99222 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99223 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99224 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99225 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99226 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99227 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99228 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99229 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99230 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99231 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99232 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99233 | Initial hospital care or subsequent hospital care | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99242 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99243 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99244 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99245 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99246 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99247 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99248 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99249 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99250 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99251 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99252 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99253 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99254 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99255 | Consultations: Office or other outpatient | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99281 | ER Level 1 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99282 | ER Level 2 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99283 | ER Level 3 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99284 | ER Level 4 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99285 | ER Level 5 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99304 | Initial Nursing Facility Care, Per Day, For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99305 | Initial Nursing Facility Care, Per Day, For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99306 | Initial Nursing Facility Care, Per Day, For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99307 | Initial Nursing Facility Care, Per Day, For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99308 | Initial Nursing Facility Care, Per Day, For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99309 | Initial Nursing Facility Care, Per Day, For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99310 | Initial Nursing Facility Care, Per Day, For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99324 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99325 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99326 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99327 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99328 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99334 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99335 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99336 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99337 | Domiciliary Or Rest Home Visit For The Evaluation And One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99341 | Home Visit For The Evaluation And Management Of A New One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99342 | Home Visit For The Evaluation And Management Of A New One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99343 | Home Visit For The Evaluation And Management Of A New One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99344 | Home Visit For The Evaluation And Management Of A New One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99345 | Home Visit For The Evaluation And Management Of A New One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99347 | Home Visit For The Evaluation And Management Of An One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99348 | Home Visit For The Evaluation And Management Of An One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99349 | Home Visit For The Evaluation And Management Of An One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99350 | Home Visit For The Evaluation And Management Of An One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99354 | Prolonged Physician Service; Office or Outpatient setting; first hour | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99355 | Prolonged Physician Service; Office or Outpatient setting; each additional 30 minutes | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99356 | Prolonged Service In The Inpatient Or Observation Setting, One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99357 | Prolonged Service In The Inpatient Or Observation Setting, Six times per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99358 | Prolonged Evaluation And Management Service Before And/or One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99359 | Prolonged Evaluation And Management Service Before And/or One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99381 | New patient, infant evaluation | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99382 | Early childhood, age 1 to 4 years old | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99383 | Late childhood, age 5 to 11 years old | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99384 | Adolescent, age 12 to 17 years old | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99385 | 18 to 39 years | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99386 | 40 to 64 years | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99387 | 65 years and older | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99391 | Established patient, infant, periodic reevaluation | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99392 | Early childhood, age 1 to 4 years old | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99393 | Late childhood, age 5 to 11 years old | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99394 | Adolescent, age 12 to 17 years old | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99395 | 18 to 39 years | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99396 | 40 to 64 years | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99397 | 65 years and older | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99406 | any office audit for codes (smoking and tobacco cessation counseling visit; intermediate, greater than 3 | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99407 | minutes up to 10 minutes) and (smoking and tobacco cessation counseling visit; intensive, greater than | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99417 | Prolonged Physician Service; Office or Outpatient setting; each additional 15 minutes | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99439 | Chronic care management services with the following required One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99451 | E-Consultations | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99483 | CPT Code Comprehensive diagnostic evaluation and management (E&M) of a patient who | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99487 | Complex Chronic Care Management Services, With The One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99489 | Complex Chronic Care Management Services, With The One time per day per | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99490 | Chronic Care Management Services, At Least 20 Minutes Of No frequency limitation | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99497 | Advance Care Planning Including The Explanation And One time per day up to | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| 99498 | Advance Care Planning Including The Explanation And One time per day up to | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| A4267 | Contraceptives , , A4269U1, A4269U2, A4269U3, A4269U4, A4269U5 and | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| A4268 | Contraceptives , , A4269U1, A4269U2, A4269U3, A4269U4, A4269U5 and | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| A4565 | 600-1034 – Slings ( ) Reimbursement | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| E1399 | under with remarks added to the claim | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G0270 | • CPT-4 Code – MNT: reassessment and subsequent intervention(s) following second referral in | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G0271 | • CPT-4 Code – MNT, reassessment and subsequent intervention(s) following second referral in | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G0442 | 600-1044 – and CHDP Program Reimbursement for Alcohol Misuse Screening | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G0506 | Comprehensive Assessment Of And Care Planning For Patients One time per member | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G9008 | U8 ECM Outreach in Person: Provided by Clinical Staff. Other Bill in 15-minute | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G9012 | U8 ECM Outreach in Person: Provided by Non-Clinical Staff. Bill in 15-minute | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G9919 | Score 4 or greater (high risk), results are positive | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| G9920 | Score between 0-3 (low risk), results are negative | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| H0014 | o Sobering Center: Alcohol And/Or Drug Services; Ambulatory Detoxification | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| H0044 | U2 Housing Deposits Bill once within the 6-month authorized period for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| H0049 | 600-1044 – and CHDP Program Reimbursement for Alcohol Misuse Screening | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| K0823 | o For example, “member owns a .” | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| Q3014 | Site Facility Fee | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| S5170 | a. Home Delivered Meals, Including Preparation; Per Meal (Not Payable By | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| S5199 | Contraceptives , , A4269U1, A4269U2, A4269U3, A4269U4, A4269U5 and | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| S9470 | c. Nutritional Counseling, Dietitian Visit (Not Payable By Medicare) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| S9977 | b. Meals, Per Diem, Not Otherwise Specified (Not Payable By Medicare) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| T1014 | Transmission Cost (per minute for maximum of 90 min. per patient) | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| T1028 | Assessment of home, physical and family environment, to determine suitability to meet patient's | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5014 | following CPT/HCPCS codes related to hearing aids will not be capped annually | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5030 | following CPT/HCPCS codes related to hearing aids will not be capped annually | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5040 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5050 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5060 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5070 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5080 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5120 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5130 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5140 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5150 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5171 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5172 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5180 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5181 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5190 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5210 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5211 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5212 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5213 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5214 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5215 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5220 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5221 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5230 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5264 | following CPT/HCPCS codes related to hearing aids will not be capped annually | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5265 | following CPT/HCPCS codes related to hearing aids will not be capped annually | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5267 | above prescribing physician, or by a licensed audiologist, is required. Prior authorization is required for the | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| V5298 | V5210, V5220, V5230, V5267, V5298, V5211, V5212, V5213, V5214, V5215, V5221. | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| X2995 | • : Simple wheelchair evaluation Code in remarks | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| X2997 | • : Complex wheelchair evaluation code should be added to the remarks | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| X2999 | under with remarks added to the claim | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| X4100 | Evaluation – initial 30 minutes, plus Treatment of speech, language, voice | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| X4102 | Medi-Cal and communication, and/or auditory | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| X4110 | Occupational Therapy – Treatment – Facilitated Communication | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| X4112 | Occupational Therapy – Treatment – Altered Auditory Feedback Devices | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |
| Z7610 | HCPCS , Miscellaneous Drugs and Supplies Administered | 2025-04-01 | Not listed | 97% | [PDF] 2025 Provider Manual - Central California Alliance for Health |