California Medi-Cal (DHCS) · Health Care Claim — Professional

Implementation notes for feeding the 837P transaction to California Medi-Cal (DHCS).

Envelope defaults

{
  "isaSenderQualifier": "ZZ",
  "isaReceiverQualifier": "ZZ",
  "receiverId": "MEDI-CAL",
  "versionId": "005010X222A1",
  "gsCode": "HC",
  "usageIndicator": "P"
}

Required fields

REF/REF02 — Medi-Cal Provider Number (REF*1D) at 2010AA
NM1/NM109 — Billing NPI (2010AA)

Fixed values

None.

Endpoint: Medi-Cal Point of Service (POS) / Gainwell portal