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Phone: 1-877-243-8832
Business hours:
Monday - Thursday: 9 am – 4:30 pm
Friday: 9 am – 4 pm
Fax: 1-877-329-9832

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Frequently Asked Questions

Billing & Reporting

Providers should verify billing and coding for each health plan as they may have different procedures and coding needs.

Medi-Cal

CHDP

  • Immunization Coding (being updated/coming soon)

CHDP Reimbursement for an Accelerated DTaP Immunization Schedule

  • Question: The American Academy of Pediatrics (AAP) recommends that “if pertussis is prevalent in the community, immunization can be started as early as 6 weeks of age, and doses 2 and 3 in the primary series can be given at intervals of 4 weeks.” This is similar to the CDC catch-up schedule, which also describes a 6 month minimum intervals between doses 3 and 4 and between doses 4 and 5 for young children who are behind on their immunizations.  Are these accelerated schedules for DTaP immunization reimbursed by CHDP? 
  • Answer: Yes. The Child Health and Disability Prevention (CHDP) Program allows providers to perform partial examinations for the purpose of giving necessary immunizations when another complete health assessment is not yet due. Circumstances in which providers desire to give certain immunizations before the 2-month health assessment visit must be in compliance with the interval schedule set forth by Medi-Cal. For the current California Pertussis outbreak, CHDP providers may utilize partial examinations to begin DTaP before the 2-month health assessment visit. Currently, MediCal allows the first immunization to be given at 6 weeks of age. The intervals between doses one and two. and two and three, must be at least 24 days, and the intervals between doses three and four and four and five must be at least 164 days. CHDP will reimburse providers the vaccine administration fee of $9.00 when immunizations are provided during partial screening exams. Please see the CHDP Provider Manual, sections “child health bil” page 5 and “conf clm comp” page 23 for additional information and instructions regarding partial screening examinations and completion of the PM 160.

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