Optical Ordering System
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Latest Updates -
Immediate Action Needed to Avoid Order Rejections Ahead of January 2026 Enforcement!
In accordance with the Centers for Medicare and Medicaid Services (CMS) mandate, the State of California has enacted laws in 2013 requiring all Medi-Cal claims for reimbursement to include the active, Medi-Cal enrolled Type 1 NPI of the ordering, referring or prescribing (ORP) provider, even if the provider does not send claims directly to Medi-Cal for the services they furnish.
DHCS will begin enforcing them in January 2026. At that time, claims listing an ordering or referring NPI that is not active or not enrolled in Medi-Cal will be denied.
Before DHCS begins enforcing the new policy in January 2026, ordering and referring providers must ensure they provide CALPIA Optical with their compliant and valid NPI's.
To meet this requirement (If any below is met, no action is required).
• Enroll as Medi-Cal Fee-for-Service (FFS) billing provider, with individual Type 1 NPI or
• Enroll as Medi-Cal Rendering provider or
• Medi-Cal ORP enrollment, How to Enroll
• Update your CALPIA account profile as needed.
The list of enrolled providers can be found at this data portal.
Required Next Steps:
• Verify that your ordering/referring provider is actively enrolled in Medi-Cal.
• Ensure your provider’s individual Type 1 NPI is correctly assigned to your POOLS provider profile
• Update your records immediately to prevent order rejections once enforcement begins.
Orders submitted without a valid, Medi-Cal -enrolled Ordering, Referring, or Prescribing (ORP) or Fee-for-Service (FFS) NPI type 1, individual, not an organizational, by January 2026 will be denied.
Summary of requirements for provider compliance:
• Providers must verify their ordering or referring National Provider Identifier (NPI) is Medi-Cal enrolled and active.
• Update your CALPIA Optical account profile with ORP compliant NPI’s if necessary.
• These verifications and updates need to be completed before the enforcement period begins in January 2026.
• If providers fail to ensure these conditions are met, access to CALPIA optical services may be denied.
The California Prison Industry Authority (CALPIA) is happy to announce that the new optical ordering website deployment was successfully completed on May 15th.
Thank you to all the providers that have provided feedback during the soft launch rollout via the email link provided below. Our team will continue to monitor the Optical Feedback email.
If you have any questions, feedback, or experience any issues, please don't hesitate to reach out to us via email.
The California Prison Industry Authority (CALPIA) is not a patient point of contact regarding access to, requesting copies, or requesting amendments to their health information records. All inquiries shall be directed to the optometrist or optician that the patient ordered from. CALPIA does not process disclosure authorization communications and will refer all such patient inquiries to the appropriate optometrist or optician.
Please refer to the CALPIA FAQ item #14 for additional information on optometrist and optician responsibilities with regards to patient data rights.
For all CALPIA customer service related issues we recommend you contact your assigned lab via email: Your lab assignment can be found in the upper right-hand corner of your RX order. see example here.
Please include your Rx control number and provider account number in all communications
Email to: Valley State Prison (VSP)
Email to: Central California Women's Facility (CCWF)
Email to: CSP-Solano (SOL)
