Erroneous Payment Correction for Laboratory Services Rate Update

An article that published in the July 2013 Medi-Cal Update stated that no Erroneous Payment Correction (EPC) would be performed for claims previously processed under a higher laboratory services rate. This article clarifies that an EPC will be initiated for claims that were adjudicated prior to the system update on July 29, 2013. Effective July 29, 2013, the reimbursement rates changed for certain laboratory services that were higher than 80 percent of the 2011 and/or 2012 Medicare rate. Any claims processed on or after July 29, 2013, with a date of service in 2011, 2012 or 2013, are subject to the updated rates. An EPC will be initiated to adjust those claims adjudicated prior to July 29, 2013.