MedicaidBilling CodesHigh impact
05-28-2026 Required Surgical Modifiers IE LA SAC SD
Molina Healthcare·CA · Orthopedics, General Surgery, Cardiothoracic Surgery +9 more·Provider Bulletin
Effective date
Sep 1, 2026
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California now requires appropriate modifiers on all surgical procedure codes for Medi-Cal claims. Claims submitted without required modifiers will be returned to providers for correction starting September 1, 2026.
Action Required
By September 1, 2026: Billing team must update procedures to ensure all surgical codes CPT 10000-69999 and HCPCS Z1200-Z1212 include appropriate modifiers (AG, 50, 51, 80, 99, UA, UB). Update billing system edits to require modifiers before claim submission. Primary surgeons must use modifier AG on highest-valued procedure. Update encounter forms and train staff on modifier requirements. Claims without modifiers will be returned for correction.