Medi-Cal Update July2021 Bulletin: Radiology Reimbursement Rate Adjustment

Effective retroactively for dates of service on or after January 1, 2019 and January 1, 2020, radiology reimbursement rates have been adjusted. In pursuant to Senate Bill 853 (Chapter 717, Statutes of 2010), the Department of Health Care Services (DHCS) is required to adjust Medi-Cal reimbursement rates for radiology services so they do not exceed 80 percent of the corresponding Medicare rate.

The updated radiology reimbursement rates are available on the Medi-Cal Rates page.

An Erroneous Payment Correction (EPC) will be implemented to reprocess claims with dates of service on or after the effective date of this billing policy that were appropriately submitted based on the guidance published in this article, but were paid based on the previously published rate.

Source: https://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/gm202107.aspx