Manual of Criteria
This document is a compilation of criteria which apply to some services provided under the Medi-Cal program, California's version of the Medicaid program, and Title XIX of the Social Security Act. The criteria published in this manual, while not exhausting the range of services covered by Medi-Cal will nonetheless help to standardize consultants' exercise of professional judgment.
Revision List
Introduction
Regulatory Statutory Authority
Statement of Department of Health Care Services' Intent
Emergency and Pregnancy Related Services
Criteria Manual Chapter 5.0
Integumentary
Musculoskeletal
Respiratory
Mediastinum Diaphragm
Digestive
Urinary
Male Genital
Female Genital
Nervous
Eye, Ear and Nose
Psychiatric Diagnoses
Acute and Transitional Inpatient Care Administrative Days
Stable For Transport Guidelines
Acute Inpatient Intensive Rehabilitation
Criteria For Obstetric and Newborn Services
Criteria Manual Chapter 6.2, Inpatient Newborn Services
Criteria Manual Chapter 6.3, Obstetrical and Delivery Services in Non Contract Hospitals in Closed Areas
Criteria Manual Chapter 6.4, Comprehensive Perinatal Services Program (CPSP)
Criteria Chapter 7.0, Criteria For Long Term Care Services
Intermediate Care Facility Services
Intermediate Care Facility Services For Developmentally Disabled and Intermediate Care Facilities For Developmentally Disabled Habilitative
Criteria Manual Chapter 9.1, Criteria For Home Health Agency Services
Criteria Chapter 10.1, Criteria For Authorization of Drugs and Medical Supplies
Criteria Manual Chapter 11, Criteria For Hospice Care
Criteria Manual Chapter 12.1, Criteria For Medical Transportation and Related Services
Criteria Manual Chapter 13.0, Criteria For Durable Medical Equipment
Criteria Manual Chapter (13.1), Antidecubitus Care (ADC) Support Surfaces
Criteria Manual Chapter 13.2, Osteogenesis Stimulator Devices To Accelerate The Healing Of Selected Bone Fractures