Welf. & Inst. Code, § 14105.49 · Article 3. Administration
Welf. & Inst. Code, § 14105.49
Text — As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
(a) (1) The department shall establish a list of Healthcare Common Procedure Coding System (HCPCS) codes billable to the Medi-Cal program and reimbursement rates, subject to Section 51319 of Title 22 of the California Code of Regulations, hearing aids, and the list shall be published in the Medi-Cal Provider Manual.
(2) The department may implement this section by provider manual or bulletin. Notwithstanding the provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of the Government Code), actions of the department under this section shall not be subject to the rulemaking provisions of the Administrative Procedure Act or to the review and approval of the Office of Administrative Law.
(b) The maximum reimbursement rate for hearing aids shall not exceed the lesser of the following:
(1) The maximum allowable amount established by the department.
(2) The one-unit wholesale cost, plus a markup determined by the department.
(3) The billed amount.
(4) The rate established by the department’s contracting program.
(c) The maximum reimbursement rate for hearing aid supplies and accessories shall not exceed the lesser of the following:
(1) The retail price.
(2) The wholesale cost, plus a markup determined by the department.
(3) The billed amount.
(4) The rate established by the department’s contracting program.
(d) The maximum reimbursement rate for molds or inserts shall not exceed the lesser of the following:
(1) The maximum amount allowable established by the department.
(2) The billed amount.
(3) The rate established by the department’s contracting program.
(e) The maximum reimbursement for repairs, subsequent to the guarantee period, shall not exceed the lesser of the following:
(1) The invoice cost plus a markup determined by the department.
(2) The billed amount.
(3) The rate established by the department’s contracting program.
Notes and commentary — not statutory text
History
Amended by Stats. 2006, Ch. 74, Sec. 67. Effective July 12, 2006.
Source of truth
- Edition
- As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
- Official file
- https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14105.49.
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- sha256 74bc7e43a77e1f90549c3265c1028d03e952c18aca4635904919abf5f27972c5
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- compose_ca.py 2026-10-22: the Legislative Counsel's CAML content files read by a tokenizer (caml_readers.reader_a); an independent xml.etree reading (caml_readers.reader_b) agrees on every section
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Welfare and Institutions Code
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