MedicaidBilling CodesHigh impact
Update: ICD-10-CM Requirements for FQHCs, RHCs, IHS-MOA and Tribal FQHCs
Medi-Cal·CA·Coding
Effective date
Oct 15, 2026
We identified it
Aug 15, 2026
Summary
Effective October 15, 2026, Medi-Cal requires FQHCs, RHCs, IHS-MOA clinics, and Tribal FQHCs to include one or more valid, clinically appropriate ICD-10-CM diagnosis codes on all claim submissions (UB-04 or 837I forms). Claims submitted without valid ICD-10-CM diagnosis codes will be denied.
Action Required
By October 15, 2026: Billing team must ensure all FQHC, RHC, IHS-MOA, and Tribal FQHC claims include at least one valid, clinically appropriate ICD-10-CM diagnosis code in applicable fields on UB-04 (paper) or 837I (electronic) claim forms. Update billing software validation rules to reject claims missing diagnosis codes before submission. Train billing staff and providers on ICD-10-CM requirements using the UB-04 Completion: Outpatient Services section of the Medi-Cal provider manual. Failure to include valid diagnosis codes will result in claim denials. Verify your organization type qualifies under this requirement (FQHC, RHC, IHS-MOA, or Tribal FQHC). Monitor for future Medi-Cal Updates with additional implementation details.