Effective Date Changed for Laboratory Services Rate Update

An article that published in the July 2013 Medi-Cal Update announced reimbursement rate changes for certain laboratory services, effective for claims processed on or after July 22, 2013. Due to testing issues, these changes have not yet implemented, causing delays in adjudicating claims correctly. The new effective date for the reimbursement rate updates is July 29, 2013.

Effective July 29, 2013, the reimbursement rates for certain laboratory services that were higher than 80 percent of the 2011 and/or 2012 Medicare rate will change. Any claims processed on or after July 29, 2013, with a date of service in 2011, 2012 or 2013, will be subject to the updated rates. No Erroneous Payment Corrections (EPCs) will be initiated to adjust those claims previously processed under the higher rate. However, any claims that are reprocessed after the rate update will be subject to the most current rate.