Medi-Cal ADJUSTMENT OF CLAIMS DUE TO CLINICAL LABORATORY RATES UPDATE

The Department of Health Care Services (DHCS) updated provider reimbursement rates for clinical laboratory or laboratory services, effective for dates of service on or after July 1, 2021. If the rate was increased, the adjustment is positive. If the rate was reduced, the adjustment is negative.

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 Remittance Advice Details (RAD) forms beginning July 28, 2022 (for positive adjustments), and September 8, 2022 (for negative adjustments), with RAD code 0893: Retroactive rate adjustment.

Source: https://files.medi-cal.ca.gov/pubsdoco/epc/2022/31824_p43624.pdf