2011 California Code
Health and Safety Code
DIVISION 10.5. STATE DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS [11750 - 11970.45]
CHAPTER 3.4. Medi-Cal Drug Treatment Program
Section 11758.44

(a) In addition to narcotic treatment program services, a narcotic treatment program provider who is also enrolled as a Medi-Cal provider, may provide medically necessary medical treatment of concurrent diseases, within the scope of the provider s practice, to Medi-Cal beneficiaries who are not enrolled in managed care plans. Medi-Cal beneficiaries enrolled in managed care plans shall be referred to those plans for receipt of medically necessary medical treatment of concurrent diseases.

(b) Diagnosis and treatment of concurrent diseases of Medi-Cal beneficiaries not enrolled in managed care plans by a narcotic treatment program provider may be provided within the Medi-Cal coverage limits. When the services are not part of the substance abuse treatment reimbursed pursuant to Section 11758.42, services shall be reimbursed at Medi-Cal program outpatient rates. Services reimbursable under this section shall include, but are not limited to, all of the following:

(1) Medical treatment visits.

(2) Diagnostic blood, urine, and X-rays.

(3) Psychological and psychiatric tests and services.

(4) Quantitative blood and urine toxicology assays.

(5) Medical supplies.

(c) A narcotics treatment program provider, who is enrolled as a Medi-Cal fee-for-service provider, shall not seek reimbursement from a beneficiary for substance abuse treatment services, if services for treatment of concurrent diseases are billed to the Medi-Cal fee-for-service program.

(Added by Stats. 1996, Ch. 1027, Sec. 3. Effective January 1, 1997.)