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DMC-ODS Playbook

The Drug Medi-Cal ODS (DMC-ODS) Playbook is a collection of all requirements and guidelines from the DMC-ODS Billing Manual. Included are myAvatar specific recommendations for system configuration to comply with the CalAIM requirements. The Playbook also contains Cal-PM and MSO enhancement information.

The Playbook is divided into sections corresponding to the Billing Manual.

Playbook sections
Section Description/Notes
Client Eligibility

Chapter 3 of Billing Manual - This section details Medi-Cal Eligibility and Aid Codes.

Covered Services

Chapter 4 of Billing Manual - This section details DMC- ODS Covered Services and Levels of Care.

Claim Processing

Chapter 4 of Billing Manual - This section details DMC- ODS Covered Services and Levels of Care.

Chapter 5 of Billing Manual - This section relates to the SD/MC Claiming Process.

Cal-PM and MSO Enhancements This section give information on Cal-PM and MSO Enhancements
Funding

Chapter 6 of Billing Manual - This section provides information on the funding relationship between Federal Share, State share and Proposition 30, and the County Share.

Disciplines

Table 1 in Billing Manual - These abbreviations of Disciplines are used in the Service Code lists.

Place of Service Codes

Table 2 in Billing Manual - These are the Place of Service Codes used with Service Codes.

Modifiers

Table 3 in Billing Manual - These are the Modifiers that are attached to Service Codes.

Taxonomy Codes

Appendix 1 - A list of First Four Alpha-numeric Characters of Taxonomy codes.

Definitions

Appendix 2 - A list of common terms in the Billing manual.

DMC Procedure Code

Appendix 3 - A list of Procedure codes included as benefits for DMC-State Plan counties.

Service Codes List
  • Assessment Codes
  • SUD Crisis Intervention Codes
  • Medication Codes
  • Mobile Crisis Codes
  • Treatment Planning Codes
  • Individual Counseling Codes
  • Group Counseling Codes
  • Care Coordination Codes
  • Recovery Services Codes
  • Supplemental Service Codes
  • Discharge Services Codes
  • Family Therapy Codes
    • Peer Support Services
    • Existing 24-Hr and day services