New Medi-Cal Procedure/Drug Code Limitation List

The list of providers on the Procedure/Drug Code Limitation List (P/DCL List) is being published in the Medi-Cal Update and is also available on the Medi-Cal Web site. Additions and changes display in bold type. Providers placed on the P/DCL List are not eligible to receive reimbursement for the procedure or drug code services for which the providers are under restriction. In addition, other providers who fill orders for lab tests, drugs, medical supplies or any other restricted services prescribed or ordered by the provider under restriction will not be reimbursed. The limitation becomes effective after the Department of Health Services gives the provider notice of the proposed limitation and no appeal is submitted within 45 days, or following denial of an appeal. After 18 months, the P/DCL automatically ceases.