Central California Alliance for Health (the Alliance) is notifying you that the Department of Health Care Services (DHCS) has implemented two retroactive rate adjustments for select clinical laboratory or laboratory services to be 80 percent of the lowest maximum allowance established by the federal Medicare program for the same or similar services. DHCS first implemented the rate adjustment for dates of service on or after April 1, 2019 and then subsequently released a second adjustment to laboratory codes for dates of service on or after January 1, 2020. The Alliance decided to wait to implement the rate adjustments until DHCS released the new rates for the subsequent adjustment, which occurred on March 15, 2021.
The Alliance has implemented the above referenced rate adjustments for claims with dates of service on or after July 1, 2020 and claims adjustments will be made incrementally. No action is required on your part. Additional information regarding these adjustments can be found on the Medi-Cal website here:
If you have any questions regarding the rate adjustments, please contact your Provider Relations Representative at (800) 700-3874 ext. 5504.