Medi-Cal Rate Methodology Raised to 100% of Medicare

The recently executed California Assembly Bill (No 133), raises the Medi-Cal rate methodology to 100% of Medicare for laboratory services and prevents future retroactive reimbursement reduction and recoupments.   The legislation successfully removes the 80% of Medicare cap on payments and resulting retroactive recoupment. 

The transition to a cap of 100% of Medicare will be phased in over the next year.

• July 1, 2021 to June 30, 2022 rates will revert to the 2019 rates, prior to the 2020 cuts
• July 1, 2022 rates will equal 100% of Medicare or rate calculated by data submission

For further information on the impact to your business, non-XiFin customers can contact Diana Richard at drichard@xifin.com. Customer Account/Service Managers for current XiFin clients will assist in providing estimated financial impact to these changes.