EPC Letter – P53153: Retroactive Rate Adjustment to Radiology Claims for Select CPT Codes

(DHCS) updated provider reimbursement rates for the following radiology codes, effective retroactively for dates of service from April 1, 2017. If the rate was increased, the adjustment is positive. If the rate was reduced, the adjustment is negative.

70486 70487 70496 70540 70542 70543 72080 72114 72285 72295 73219 74710 75561 75565 75600 75605 75625 75630 75726 75736 75741 75743 75746 75774 75825 75827 75842 75885 76380 76641 76642 76802 76810 76819 76946 77012 77021 77073 77077 77080 77081 77085 77334 77470 78496

No action is required on your part. The California Medicaid Management Information System (MMIS) Fiscal Intermediary, will adjust the affected claims. These adjustments will appear on RAD forms beginning March 5, 2020, for positive adjustments, and April 2, 2020, for negative adjustments, with RAD code 0893: Retroactive rate adjustment.