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Published: May 3, 2020

Medi-Cal Payment for ACEs Screening

A key part of the work of Surgeon General Burke-Harris is the ACEs Aware initiative. Beginning January 1, 2020, DHCS will provide a $29/patient payment to Medi-Cal providers for screening their patients for ACEs. Eligible Medi-Cal providers who screen Medi-Cal patients for ACEs can receive payment as of January 1, 2020. Beginning on July 1, 2020, Medi-Cal providers must have taken a certified Core Training and self-attested to completing the training to continue to receive Medi-Cal payment for ACE screenings.  The CAFP’s monograph and Homeroom module are both certified Core Training activities.

Billing and coding are based upon the beneficiary’s total ACE score. The ACE score refers to the total reported exposure to the ten ACE categories indicated in the adult ACE assessment tool or the first box of the PEARLS tool. ACE scores range from 0 to 10.

To bill Medi-Cal, providers should use the Healthcare Common Procedure Coding System (HCPCS) billing codes based upon the results of the screening.

  • HCPCS code G9919 is used for screens that have a score of 4 or greater (high risk)
  • HCPCS code G9920 is used for screens that have a score of 0 to 3 (lower risk)

Billing requires that the completed screen was reviewed, the appropriate tool was used, results were documented and interpreted, results were discussed with the beneficiary and/or family, and any clinically appropriate actions were documented. This documentation should remain in the beneficiary’s medical record and be available upon request.

For more information on payment please go to:  https://www.acesaware.org/about-aces-aware/faq/

To receive Medi-Cal patient screening payment you must attest to completing an educational training module:  https://www.medi-cal.ca.gov/TSTA/TSTAattest.aspx

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