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ICD-10-CM Requirements for FQHC, RHC, IHS-MOA and Tribal FQHC Providers
Act
by Oct 15, 2026
Effective date
Oct 15, 2026
Identified
Oct 10, 2026
Summary
Effective October 15, 2026, Medi-Cal requires at least one clinically appropriate ICD-10-CM code on all UB-04 and 837I claims submitted by FQHCs, RHCs, IHS-MOA, and Tribal FQHCs. Billing teams must ensure diagnosis codes are present on all outpatient claims for these provider types to avoid claim denials.
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What to do
by Oct 15, 2026 · 5 steps
01Billing team must implement a mandatory requirement for at least one ICD-10-CM diagnosis code on all UB-04 claim forms and 837I electronic claims submitted to Medi-Cal by Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Indian Health Services Memorandum of Agreement (IHS-MOA) providers, and Tribal FQHCs.
02Verify that billing software enforces ICD-10-CM code inclusion before claim submission.
03Review the UB-04 Completion: Outpatient Services section of the provider manual for specific coding instructions.
04Providers should monitor future Medi-Cal Updates for revised manual sections.
05Claims submitted without at least one clinically appropriate ICD-10-CM code will be non-compliant.
Original notice
ICD-10-CM Requirements for FQHC, RHC, IHS-MOA and Tribal FQHC Providers
mcweb.apps.prd.cammis.medi-cal.ca.gov · Always check the source before changing claims.