HPSM Medi-Cal

Doctors & Specialists

In general, HPSM will only cover services you receive from Medi-Cal providers in HPSM’s network. You are covered for services from a non-network provider in the United States only for medical emergencies, for urgent care outside of the plan’s service area or when HPSM pre-approves coverage for a visit to non-network provider.

Referrals

Preauthorization of referrals are not required if your doctor refers you to a specialist within the HPSM network. You can use the provider search form to quickly find in-network specialists, pharmacies, clinics and hospitals.

If you need to be referred to a specialist outside the HPSM network, the specialist must obtain approval from your primary care provider (PCP) before you receive services. Contact your PCP to learn more. You can find your PCP's phone number on your HPSM member I.D. card. Your PCP will then consult HPSM's Prior Authorization Required List to determine whether the service requires preauthorization.

Find a provider

Use the search form to quickly find in-network primary care providers, specialists, pharmacies, clinics and hospitals

  • Search by provider name, health plan, location or type of provider
  • Click on a provider's name in the search results to see additional information
  • Search results include links to interactive maps and directions
  • Print or save the information for individual providers
  • Weekly updates ensure you get the most accurate results

Request a Printed Copy

If you would like a provider directory mailed to you, please send an email to providerdirectoryrequests@hpsm.org with the following information:

  • Your first and last name
  • Daytime phone number (in case we need to call you about your request)
  • Mailing address
  • Which program's provider directory you are requesting (HealthWorx HMO, ACE, CareAdvantage CMC, Healthy Kids HMO, or Medi-Cal)

The provider directory is updated every week; however there may be incorrect or new information about a provider that has not yet been updated. If you find an error, please send us the correct information by using the Provider Directory Error Report Form.

Find a dentist

Dental benefits under HPSM's Medi-Cal program are provided by Denti-Cal. To find a dentist, call 1-800-322-6384 or visit denti-cal.ca.gov.