Coverage profile
Work Medicaid California Medi-Cal across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medicaid California Medi-Cal.
Other aliases
Also known as
- 100065
- 10055
- 1473
- 3447
- 610442
- CACAID
- CAMCD
- MC051
- MDCAL
- MPM18
- SKCA0
- California Medicaid (Medi-Cal)
- CALIFORNIA MEDICAID
2027 maternity billing research
When does Medicaid California Medi-Cal change OB/GYN billing?
Starting November 1, 2026, Medi-Cal encourages obstetrical providers to submit prenatal and postpartum claims using E/M selected by time and complexity with TH. Prenatal visits require gestational-age diagnosis coding; postpartum visits require a relevant listed diagnosis and actual subcodes. CPSP providers and doulas must continue local Z1032, Z1034 and Z1038 until further notice. The article does not establish individual managed-care-plan adoption.
- Transition start
- 2026-11-01 — encouraged start
- Billing start
- 2026-11-01 — encouraged, not mandatory conversion
- Published
- 2026-09-18
- Current As Of
- October 2026
Scope: California Medi-Cal program; obstetrical providers. The article does not expressly distinguish FFS and managed care or identify individual managed-care plans.
Obstetrical Providers Encouraged to Use E&M Codes with Modifier TH. Verify the payer source before claim submission.
Frequently asked questions
Medicaid California Medi-Cal payer FAQs
What is the payer ID for Medicaid California Medi-Cal?
The primary payer ID for Medicaid California Medi-Cal is 100065. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What are the 837 payer IDs for Medicaid California Medi-Cal?
The 837P and 837I payer ID for Medicaid California Medi-Cal is 100065 via Stedi.
What is the 835 payer ID for Medicaid California Medi-Cal?
The 835 payer ID for Medicaid California Medi-Cal is 100065 via Stedi.
What is the 270 payer ID for Medicaid California Medi-Cal?
The 270 payer IDs for Medicaid California Medi-Cal are 100065 via Stedi and 100065 via Availity.
What state does Medicaid California Medi-Cal operate in?
Medicaid California Medi-Cal operates in CA.
Routing reference
Medicaid California Medi-Cal payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | Medicaid California Medi-CalSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | CASource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 100065Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 100065Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 100065Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 100065Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 100065Source: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Medicaid California Medi-Cal. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: MEDICAID CALIFORNIA MEDI-CAL. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.