California Medi-Cal
Complete guide to California Medi-Cal enrollment, managed care plans, and provider requirements
Enrollment Time
60-120 Days
MCOs
25+ Plans
Timely Filing
180 Days
Model
Managed Care
California Medi-Cal Overview
Medi-Cal is California's Medicaid program, serving over 14 million beneficiaries — one of the largest Medicaid programs in the nation. Most beneficiaries are enrolled in managed care plans organized by county.
Key California-Specific Features:
- • County-based plans: Managed care plans vary by county
- • Two-plan model: Many counties have 2 commercial plans + 1 local initiative
- • DHCS oversight: Department of Health Care Services manages the program
- • CalAIM: Major redesign improving care coordination and behavioral health integration
Provider Enrollment Process
Step-by-Step California Medi-Cal Enrollment
1. Enroll with California DHCS
All providers must first enroll with the state Medi-Cal program:
- • Complete Provider Application and Certification (PAC) form
- • Submit online through Provider Enrollment Division
- • Provide California license, NPI, TIN, and other documentation
- • Pay enrollment fee if applicable
- • Processing time: 60-90 days
Important California Requirement
California requires fingerprinting and background checks for many provider types. Schedule this early in the enrollment process.
2. Contract with Managed Care Plans
After DHCS enrollment, contract with individual managed care plans:
- • Identify which plans operate in your county
- • Submit credentialing application to each plan
- • Most use CAQH for primary verification
- • Processing time: 60-120 days per plan
Total Timeline
- • DHCS enrollment: 60-90 days
- • MCO credentialing: 60-120 days per plan
- • Total process: 120-210 days from start to first payment
California Medi-Cal Managed Care Plans
Note: California has 25+ managed care plans across 52 counties. Plans available vary by region. This list includes major statewide and regional plans.
Aetna Better Health of California
Anthem Blue Cross
Blue Shield of California Promise Health Plan
California Health & Wellness
Care1st Health Plan
Health Net
Inland Empire Health Plan (IEHP)
Kaiser Permanente
L.A. Care Health Plan
Molina Healthcare
Health Plan of San Joaquin
Health Plan of San Mateo
Partnership HealthPlan of California
Santa Clara Family Health Plan
Provider tip: Focus on contracting with 3-5 plans in your county. Check plan enrollment data to prioritize the largest plans in your area.
Behavioral Health Services
Medi-Cal Behavioral Health Coverage
California has a unique behavioral health delivery system with services split between managed care plans and county mental health plans (MHPs).
Covered by MCOs
- • Outpatient therapy (up to 20 visits)
- • Medication management
- • Crisis intervention (initial)
- • Mild-to-moderate mental health
- • SUD treatment (most services)
Covered by County MHPs
- • Specialty mental health services
- • Services for serious mental illness
- • Intensive case management
- • Intensive outpatient programs
- • Psychiatric inpatient care
CalAIM Behavioral Health Changes
Starting 2027, California is transitioning behavioral health services to managed care plans under CalAIM. This will significantly change the delivery model. Stay updated on implementation timelines.
Important Contacts
DHCS (Dept of Health Care Services)
Provider Enrollment
1-916-323-1945
Provider Inquiry Line
1-800-541-5555
Provider Portal
DHCS Provider PortalMedi-Cal Rx (Pharmacy)
Pharmacy Provider Services
1-800-977-2273
Medi-Cal Rx Website
Medi-Cal Rx Portal