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Medi-CalMedicaid · Documentation · Provider Bulletin · CAHigh impact

Ordering, Referring and Prescribing: FAQs Available

Effective date
Not stated in the notice
Identified
Oct 21, 2026

Summary

DHCS is enforcing a CMS mandate requiring providers billing Medi-Cal to include the Ordering, Referring, and/or Prescribing National Provider Identifier (NPI) on claims for covered goods and services. DHCS has published FAQs to assist with enrollment and billing instructions for complying with this requirement.

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What to do

Action · 6 steps
01Billing team should verify current compliance with the CMS mandate to include Ordering, Referring, and/or Prescribing NPI on all Medi-Cal claims.
02Review the DHCS Prescribing and Billing Providers FAQs (available on the DHCS website and linked through the Ordering, Referring and Prescribing web page) for enrollment requirements and billing instruction updates.
03Update billing software and claim submission workflows to capture and transmit the ordering/referring/prescribing provider NPI on all applicable Medi-Cal claims.
04Confirm that providers enrolled in Medi-Cal Rx and CA-MMIS billing are following current NPI inclusion requirements.
05Note: The source does not state a specific future effective date or deadline; 'enforcing' indicates ongoing or imminent enforcement.
06Confirm current applicability and implementation status with DHCS.

Original notice

Ordering, Referring and Prescribing: FAQs Available
mcweb.apps.prd.cammis.medi-cal.ca.gov · Always check the source before changing claims.
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