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Medi-CalMedicaid · Coverage · Provider Bulletin · CA · PsychiatryHigh impact

One-Time Timeliness Waiver for LMFT and Psychological Associate Services Delivered by a RHC or FQHC

Act
by Nov 29, 2026
Effective date
Sep 29, 2026
Identified
Sep 30, 2026

Summary

DHCS has implemented a one-time 60-day timeliness waiver (September 29, 2026 to November 29, 2026) allowing RHCs and FQHCs to submit and receive reimbursement for Psychological Associate services (under licensed clinical psychologist supervision) and LMFT services with dates of service on or after January 1, 2025, that were previously held or unpaid. Claims must meet specific billing code, practitioner identification, and documentation requirements to qualify.

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What to do

by Nov 29, 2026 · 9 steps
01Billing team must identify and resubmit all eligible held or unpaid Psychological Associate and LMFT claims with dates of service on or after January 1, 2025.
02For each claim submission.
03Verify practitioner type is clearly marked in Box 80 (Remarks) of UB-04 or 837 form using either 'Timeliness Waiver for Psychological Associate' or 'Timeliness Waiver for LMFT'.
04Ensure claims are billed under Revenue Code 0521 with Procedure Code T1015 or T1015 SE (or Revenue Code 900/529 with G0469/G0470 for dual-eligible non-managed care members).
05Verify supervising licensed clinical psychologist's NPI is included for Psychological Associate services.
06Confirm both clinically appropriate diagnosis code and procedure code in informational line are present.
07Confirm no duplicate submissions or incorrect billing codes exist.
08Verify no same-day medical/mental health service was previously adjudicated for the same member on the date of service.
09Resubmit claims within the 60-day window or they will permanently lose eligibility.
If missed: Failure to meet all requirements will result in claim denial and no reprocessing.

Codes mentioned

T1015G0469G0470

Original notice

One-Time Timeliness Waiver for LMFT and Psychological Associate Services Delivered by a RHC or FQHC
mcweb.apps.prd.cammis.medi-cal.ca.gov · Always check the source before changing claims.
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Related policy hubs

Medi-Cal policiesCA policy changesPsychiatryCode T1015Code G0469Code G0470

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