Quarterly News and Updates

March 2026

• Clinical Updates
• Upcoming Events & Training Opportunities
• Family PACT Enrollment & Portal Updates
• Family PACT Policy Updates & Reminders
• Medi-Cal Information & Bulletins
• Contact Us & Helpful Resources

The Office of Family Planning has promotional flyers that provide a clear, and easy-to-understand overview of the Family PACT Program. The materials highlight the range of reproductive health services covered at no cost for eligible Californians, including contraception, STI/HIV testing and treatment, and cervical cancer screening.

The flyers also discuss eligibility, emphasize confidentiality, and provide information on how to apply and locate a Family PACT provider.

Please share these resources to share with your clients and communities.

Family PACT Flyers:

• Get To Know Family PACT (English | Spanish | Both)
• What Can Family PACT Do For You? (English | Spanish)

FDA Approves Updated Nexplanon Label and Launches New REMS

Effective January 16, 2026, the U.S. Food and Drug Administration (FDA) has approved the Supplemental New Drug Application (sNDA) for Nexplanon (68 mg etonogestrel implant), extending its approved use from 3 years to up to 5 years for pregnancy prevention. 

• Full Prescribing Information (for clinicians) and Patient Labeling have been updated accordingly.
• Clinical trial data (NCT04626596) showed zero pregnancies during years 4–5 and no new safety concerns across BMI ranges of 17.2 to 64.3 kg/m², including 38% with BMI ≥30 kg/m². 

All clinicians performing Nexplanon insertions or removals must now complete FDA-required Risk Evaluation and Mitigation Strategy (REMS) certification.  

• Clinical Note:

o In 2018, the insertion location changed from the sulcus between the biceps and the triceps muscles to the current insertion site, which is 3-5 cm posterior to (below) the sulcus. This decreases the risk of migration and neurovascular injury. This 2026 label change does not change the recommended insertion location. [See “Insertion Procedure” on page 5 of the Full Prescribing Information.]

•  Requirements of the Nexplanon REMS program include:

o  Healthcare providers must certify with the program by enrolling and completing training on the proper insertion and removal of Nexplanon prior to first use. 

o  Wholesalers and distributors must be registered with the program and must only distribute to certified pharmacies and certified healthcare providers.

Instructions for providers to enroll and certify in the REMS program:

• Visit: https://www.nexplanonrems.com/
• Following review of the updated Prescribing Information and Healthcare Provider Guide, providers are to create a Nexplanon REMS account, take a Knowledge Assessment, and complete an Enrollment Form to obtain REMS certification.
• The REMS enrollment period is February 23, 2026, through August 23, 2026.

o Providers who do not enroll during this time period will not be able to purchase Nexplanon after the end of this 6-month certification period. 

• Providers who have not been previously trained by Organon – or those who did not complete the 2018 re-training – can visit the Nexplanon REMS website to enroll in the REMS program and receive information on the required training.

o All health care providers must receive instruction and training prior to performing insertion and/or removal of Nexplanon. 

Resources:

• Nexplanon REMS: https://www.nexplanonrems.com/
• Updated FDA: Full Prescribing Information

IMPORTANT: Office of Family Planning Reminder

Family PACT Providers are required to offer the Nexplanon contraceptive implant onsite. Each site enrolled in the Family PACT Program must identify, at a minimum, one practitioner trained to provide Long-Acting Reversible Contraception (LARC) services – including insertion and removal of the contraceptive implant – onsite. See Family PACT Policies, Procedures and Billing Instructions Manual (PPBI), Section Provider Enrollment and Responsibilities page 5.

Image source: PR Newswire

Miudella Copper IUS Contraception Added as 
Medi-Cal and Family PACT Benefit

Family PACT Bulletin 222 | March 2026

Effective January 1, 2026, the copper 175 mm² intrauterine device (IUD), commercial name Miudella^® has been added as a benefit of Medi-Cal and the Family PACT Program, under HCPCS code J7299 (intrauterine copper contraceptive [Miudella]).

Miudella is a hormone-free copper containing IUD approved by the FDA to prevent pregnancy for up to three years.

HCPCS code J7299 has a sex restriction of female and a frequency limit of one device every three years.

Miudella is not yet commercially available in the U.S. Once available, it will be distributed under an FDA Risk Evaluation and Mitigation Strategy (REMS) program to ensure healthcare providers are trained on the proper insertion prior to use.

Providers can anticipate more information in future communications from OFP.

The following provider manual(s) have been updated:

Family PACT Bulletin 222 | March 2026

Effective for dates of service on or after February 1, 2026, CPT® code 87626 – detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), separately reported high-risk types (e.g., 16, 18, 31, 45, 51, 52) and high-risk pooled result(s) – is a benefit under the Family PACT Program.

This is in addition to CPT codes:

• 87624 HPV, high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 56, 58, 59, 68)
• 87625 HPV, types 16 and 18 only, includes type 45, if performed

HPV tests must be billed with the ICD-10-CM diagnosis code that identifies the contraceptive methods for which the client is being seen and are reimbursable for patients 21 years of age and older.

CPT code 87626 cannot be billed with CPT codes 87624 or 87625 for the same date of service.

The following sections of the Family PACT Policies, Procedures and Billing Instructions (PPBI) Manual have been updated with the new CPT code:

• Benefits: Family Planning-Related Services (ben fam rel), see pages 5-6.
• Laboratory Services (lab), see page 39.
• Benefits Grid (ben grid), see pages 21, 35, 36, 37  

Check out the newly updated client education materials in our library of family planning and reproductive health client education materials. All these resources are available to download in both English and Spanish.

• All About Sterilization (English | Spanish)
• All About Vasectomy (English | Spanish)
• Birth Control: It's Up To Me Booklet (English | Spanish)

March: National Women & Girls 
HIV/AIDS Awareness Month

Every year on March 10 and throughout the month of March, local, state, federal, and national organizations come together to shed light on the impact of HIV and AIDS on women and girls and to show support for those at risk of and living with HIV. This year marks the 20th annual observance of National Women and Girls HIV/AIDS Awareness Day.

In the United States, about 23% of people living with HIV are women and, in 2021, women made up 20 percent of new diagnoses, according to CDC data. The highest number of new diagnoses were among women ages 25 to 44 (source: HIV.gov) 

Family PACT supports HIV prevention by covering confidential HIV testing, client‑centered counseling, and referral for HIV treatment.

Family PACT resources for clients:

• Sexually Transmitted Infections: HIV Facts (English | Spanish)
• All About the External Condom (English | Spanish)
• All About the Internal Condom (English | Spanish)
• All About Condoms and Spermicides (English | Spanish)

Medi-Cal

• Full scope Medi-Cal enrollment

California Department of Public Health (CDPH) resources:

• Office of AIDS (OA)

o  OA Homepage

o  PrEP Assistance Program: PrEP-AP Main Page

• STD Control Branch: CA STI Screening Recommendations, including HIV

March: National Women's History Month

April: Sexual Assault Awareness 
and Prevention Month

Comprehensive IUD and 
Contraceptive Implant Training

Family PACT Provider Orientation

Reaffirm Client Eligibility at Every Visit Using the Family PACT Portal

Providers are required to reaffirm client eligibility during each visit to confirm a client’s eligibility status has not changed, as stated in the Family PACT Policies, Procedures and Billing Instructions Manual (PPBI); Client Eligibility (client elig) section, page 6.

• Follow these steps to reaffirm client eligibility on the Family PACT Portal
• Job Aid: Client Management Pages

Forthcoming in April 2026

Effective April 6, 2026, the Family PACT Portal will be updated to allow Entitled Provider Staff and Site Certifiers to submit a request via the portal to backdate the effective eligibility start dates for Family PACT clients who were unable to be enrolled in the portal in real-time due to portal downtime/system outage.

Important Note:

• These backdating requests are restricted to when providers are experiencing technical issues when submitting a client application on the date eligibility has been determined. These issues can include portal outages related to scheduled system updates or other system downtimes. During these outages, the portal may be temporarily unavailable to clients and providers.
• Providers affected by these outages should continue determining eligibility using the Client Eligibility Certification (CEC) Form (DHCS 4461).

The Family PACT Portal will also be updated to reintroduce the Medi-Cal Restricted Scope questions back into the Other Health Care Coverage section.

More information coming soon on these enhancements.

March 2026

Effective March 2, 2026, the Family PACT Portal was updated to add the 2026 Income Eligibility Guidelines for the Family PACT Program. These updates will be effective for dates of service on or after April 1, 2026.

February 2026

Effective February 23, 2026, the Family PACT Portal was updated to enable Covered California (CCA) Service Center Representatives (SCRs) to access the Family PACT Portal via SAML-based Single Sign-On using CCA-managed credentials. This enhancement eliminates the need for SCRs to manage separate sign-on credentials as they continue to assist the Family PACT Portal community in unblocking accounts, resetting passwords, and enabling accounts disabled due to inactivity.

January 2026

This month marks one year since the launch of the Family PACT Portal—a major step forward in modernizing how clients and providers access Family PACT services. Introduced to enhance and streamline application, eligibility, and management processes, the Portal has created a more efficient and user‑friendly experience for both clients applying for Family PACT and providers completing eligibility determinations. Over the past year, the Portal has supported seamless enrollment, enabled better access to client information, and strengthened alignment with broader California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) systems and workflows

Thank you to all our partners, providers, and program staff whose continued collaboration and feedback have helped ensure the Portal’s successful first year. We look forward to building on this progress as we expand functionality, improve tools and training, and continue supporting high‑quality reproductive health services across California.

Family PACT providers must recertify their enrollment into the program every five (5) years or as directed by the Department of Health Care Services (DHCS). A complete application, including all required documents, must be submitted through the PAVE Provider Portal. If you’ve received a recertification letter via postal mail or email, please respond promptly to continue billing for Family PACT services.

For more information, visit the Family PACT Provider Enrollment webpage, Provider Enrollment and Responsibilities section of the PPBI, or email ProviderServices@dhcs.ca.gov with any questions.

Site Certifier for Multiple Service Locations Declaration (DHCS 4475) Update

On February 10, 2026, the Department of Health Care Services (DHCS) Office of Family Planning published the updated version of the Site Certifier for Multiple Service Locations Declaration (DHCS 4475). This form is used to request DHCS approval for one site certifier to oversee up to 10 service locations for designated clinic types specified in the Provider Enrollment and Responsibilities section of the Policies, Procedures and Billing Instructions Manual, page 8.

What Has Changed:

• Each DHCS 4475 allows the site certifier to designate one additional service location - in addition to their main location - per form.
• Provider must submit a DHCS 4475 for each additional service location.
• Additional supporting documentation is now required with each submission.
• The form has been updated with new instructions explaining how to complete and submit the request for multiple locations (up to 10).

Providers planning to designate one certifier to oversee multiple service locations (up to 10) must:

• Complete the updated Family PACT Site Certifier for Multiple Locations Declaration (DHCS-4475).
• Submit the completed form and required documentation to Providerservice@dhcs.ca.gov for review and approval.

The updated DHCS 4475 is available for download on the Family PACT website and the Medi-Cal Provider Forms web page.

Previous versions of the DHCS 4475 will no longer be accepted after March 1, 2026.

Superbill Update

The Family PACT Superbill has been updated. The Superbill is a tool that Family PACT providers can use to support their clinical practice. It is available in the Clinical Resources Forms section of the Family PACT website in both PDF and Excel formats. 

Important Notes:

• Use of this specific form is not mandatory for Family PACT providers. However, providers must obtain a client signature when a drug, device, or supply is dispensed, or when a laboratory specimen is obtained. See the sections on Provider Enrollment and Responsibilities (prov enroll res) and Program Standards (prog stand) for more information. The Superbill can be used to meet this requirement.
• The Superbill is NOT an exhaustive list of Family PACT benefits. Providers should continue to refer to the Family Pact Policies, Procedures and Billing Instructions Manual (PPBI) for the full list of covered benefits and requirements.

Helpful Superbill Tips:

• Front page lists Family Planning Services, including diagnosis codes as well as codes for office visits, procedures, and contraceptives.
• Back page lists Family Planning-Related Services, including STI and infection diagnosis codes and first-line treatments.
• Diagnosis codes are highlighted in green.
• Point-of-care tests are listed (refer to PPBI for other lab tests).
• First-line treatments are listed (refer to PPBI for alternatives).

Links:

• Superbill (Excel) - Providers can edit this version to fit their specific needs.
• Superbill (PDF)
• Superbill Overview (PDF) - A short "How to use the Superbill" Slide Deck

Medi-Cal, California’s version of the Medicaid program, offers free or low-cost health coverage to eligible people. 

For most Medi-Cal members, eligibility and benefits will stay the same. This means Medi-Cal members will continue to have access to doctor visits, hospital stays, emergency care, prescription drugs, mental health and substance use disorder treatment, preventive services (e.g., screenings and immunizations), and long-term care and transportation, when needed. 

Starting January 1, 2026, the rules about who can get full Medi-Cal benefits, including dental care, are changing. 

Some immigrants who used to qualify for full-scope Medi-Cal will no longer be eligible. These changes affect undocumented adults and some immigrants with legal status. This Immigration Status Categories Chart shows which immigration categories: 

• Can apply for full-scope Medi-Cal with full dental benefits starting on January 1, 2026. 
• Can still get full-scope Medi-Cal with emergency-only dental benefits starting on July 1, 2026.  
• Must pay a premium if enrolled in full-scope Medi-Cal with emergency-only dental benefits starting on July 1, 2027. 

DHCS Website Resources:

• Immigration Status & Changes to Medi-Cal Eligibility webpage
• Medi-Cal Immigrant Eligibility FAQs

Medi-Cal Bulletin:

• Medi-Cal Program & Eligibility Bulletin 41 | December 2025

BenefitsCal.com is the State of California’s official online portal where residents can apply for, view, renew, and manage public assistance benefits. It provides a secure, one-stop way to access programs like CalFresh (food assistance), Medi-Cal (health coverage), CalWORKs (cash aid), and other county-administered benefits, submit documents, report changes, and track case information without needing to visit a county office. The site is designed to make it easier and more convenient for Californians to handle their benefit needs online.

Medi-Cal Program & Eligibility Bulletin 42 | January 2026

Per Center for Medicare & Medicaid Services (CMS) mandate, providers that bill for goods and/or services ordered, referred or prescribed by another provider are required to list the National Provider Identifier (NPI) of the provider who ordered, referred or prescribed the goods or services being billed on the Medi-Cal claim. The ordering, referring and prescribing provider (ORP) must be enrolled as a participating provider in Medi-Cal and Type 1 (Individual) NPI even if the provider does not send claims directly to Medi-Cal for the goods or services they furnish.

To align with the CMS mandate, the Department of Health Care Services (DHCS) will be enforcing the mandate tentatively by end of first quarter 2026. In situations where an ordering and/or referring NPI is required, it is crucial that billing providers adopt a process to ensure a valid and active Medi-Cal enrolled ORP NPI is on the Medi-Cal claim for the date of service billed to avoid claim denials. If the Medi-Cal claim is not accompanied by an ORP NPI upon enforcement, the claim will be denied.

Note:

All secondary NPI (Ordering, Referring, Rendering, Attending and Admitting) on the Medi-Cal claim must be a valid Type 1 (Individual) NPI on the National Plan and Provider Enumeration System (NPPES) file and an active Medi-Cal provider enrolled through Provider Application and Validation for Enrollment (PAVE) for the date of service billed.

For more information on billing Medi-Cal claims, refer to the 837 implementation guidelines and/or the UB-04 Completion: Outpatient Services, UB-04 Completion: Inpatient Services and CMS-1500 Completion sections of the Provider Manual.

Providers and billers may check the Profile of Enrolled Medi-Cal Fee-for-Service (FFS) Providers web page on the California Health and Human Services Open Data Portal website to verify enrollment.

The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails shortly after urgent announcements and other updates post on the Medi-Cal website.

Medi-Cal

Medi-Cal Subscription Services - MCSS