November 08, 2024
What You Need to Know: Medi-Cal will be reprocessing previously denied claims for Flucelvax with dates of service back to August 1, 2024.
The California Department of Health Care Services (DHCS) recently updated its Medi-Cal billing policy to cover the Flucelvax influenza vaccine billed with code 90661. The new policy is effective for claims with dates of service on or after August 1, 2024.
DHCS has confirmed that its systems have now been updated to appropriately adjudicate claims moving forward. Medi-Cal will automatically reprocess affected claims dated back to August 1 that were denied before the necessary system changes were implemented.
According to DHCS, it expects those claims to be reprocessed beginning December 29, 2024. Providers may also choose to resubmit previously denied claims, as described in the CIF Submission and Timeliness Instructions section of the Provider Manual.