Cal. Welf. & Inst. Code § 14133.07
The Medi-Cal Benefits Program
Redline — January 1, 2011 → current.View current text →
Current — January 1, 2019
As of January 1, 2011
(a) Prior authorization for podiatric services provided on an outpatient or inpatient basis shall not be required when all of the following conditions are met:
(1) The services are provided by a doctor of podiatric medicine acting within the scope of his or her practice.
(2) The services are related to trauma, infection management, pain control, wound management, diabetic foot care, or limb salvage.
(3) The services are medically necessary.
(4) An urgent or emergency need for services exists at the time the service is provided.
(5) The patient was referred to the doctor of podiatric medicine by a physician.
(6) Prior authorization is not required for a physician providing the same service.
(b) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section by means of all county letters, provider bulletins, or similar instructions.
(c) This section shall become operative October 1, 2006.
(a) A doctor of podiatric medicine shall not be required to submit prior authorization for podiatric services rendered in either an outpatient or inpatient basis if a physician and surgeon providing the same services would not be required to submit prior authorization to the department.
(b) A doctor of podiatric medicine acting within their scope of practice and providing services pursuant to subdivision (a) is subject to the same Medi-Cal billing and services policies as required for a physician and surgeon, including, but not limited to, a maximum numerical service limitation in any one calendar month.
Official source: California Legislative Information. Reproduced from public-domain California statutes; confirm against the official source for the current text. Not legal advice.