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Medi-CalMedicaid · Billing Codes · Long Term Care · CA · Geriatrics, Palliative CareHigh impact

ICF/DD-CNC Waiver Services Transition to LTC and a Reference Guide is Available

Effective date
Jan 1, 2027
Identified
Oct 31, 2026

Summary

Effective January 1, 2027, ICF/DD-CNC waiver services are transitioning from outpatient billing guidelines to Long Term Care (LTC) billing guidelines. Two specific HCPCS code and modifier combinations (T2033 with modifiers U8 and U9) will no longer be reimbursable, and providers must transition to existing LTC policies and new ICF/DD-CNC billing code sets.

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What to do

Action · 4 steps
01Before January 1, 2027: Billing team must review the ICF/DD-CNC Billing Reference Guide and Long Term Care Manual to understand LTC billing instructions.
02Update billing system configuration to discontinue reimbursement claims for T2033 with modifiers U8 and U9 effective January 1, 2027.
03Identify all current claims using these code-modifier combinations and determine appropriate LTC billing code replacements.
04ICF/DD-CNC providers should familiarize themselves with the transition requirements in advance, as updated provider manual sections will be released in a future Medi-Cal Update.
If missed: Failure to transition billing codes will result in claim denials for affected services.

Codes mentioned

T2033

Original notice

ICF/DD-CNC Waiver Services Transition to LTC and a Reference Guide is Available
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 changesGeriatricsPalliative CareCode T2033

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