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22-984 Extended Benefit Coverage for Newborn Circumcision
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Medi-Cal has extended coverage for newborn circumcision from 28 days to 30 days of age, with no separate medical indication required for CPT codes 54150 and 54160. The policy also reinforces well-child visit scheduling requirements for the first 15 months of life.
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What to do
immediately · 3 steps
01Billing team must update system to allow circumcision billing (CPT 54150 and 54160) for newborns up to 30 days old instead of 28 days for Medi-Cal patients.
02Remove any prior authorization requirements for these codes.
03Ensure scheduling staff book all required well-child visits per AAP guidelines and track that children have 6+ visits by their 15-month birthday to maintain compliance.
Codes mentioned
5415054160
Original notice
22-984 Extended Benefit Coverage for Newborn Circumcision
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.