Office of Sexually Transmitted Infections (STIs) and Hepatitis C Virus (HCV)

Coverage Resources for Hepatitis C

As outlined in the Medi-Cal Preventative Services Manual, Medi-Cal covers USPSTF grade A and B recommended preventive services without cost-sharing.

Note: USPSTF recommends screening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years.

HCPCS code G0472 - Hepatitis C antibody screening, for individual at high risk and other covered indication(s) (see page 5)
CPT code 86803 - hepatitis C antibody (see page 16)
Any positive HCV antibody test should be followed by an HCV RNA test to confirm infection

HCPCS code G0567 - Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, screening, amplified probe technique (see page 13)
CPT code 87521 - Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed (see page 17)
A positive HCV RNA test confirms active infection

Medi-Cal providers may now dispense the full course of HCV treatment at the initial visit because on Oct. 1, 2025, the Medi-Cal Rx Contract Drugs List was updated to remove the quantity limit restrictions for HCV medications.
Treatment can be provided following simplified algorithms, including for people who are actively injecting drugs (AASLD guidelines). Injection drug use does not alter treatment success and should not delay treatment initiation (p.1). The diagnosis restriction was removed for all HCV treatment drugs on the Medi-Cal Rx Contract Drugs List, on March 1, 2024.

The Justice-Involved (JI) Reentry Initiative allows eligible Californians who are incarcerated to enroll in Medi-Cal and receive a targeted set of services in the 90 days before their release.

Enhanced Care Management (ECM) is a new statewide Medi-Cal benefit available to eligible members with complex needs, including connections to the quality care they need.