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Update to Medi-Cal lab rates

Central California Alliance for Health (the Alliance) is notifying providers that the Department of Health Care Services (DHCS) adjusted certain Medi-Cal reimbursement rates for clinical laboratory or laboratory services.

Assembly Bill 133 (Committee on Budget, Chapter 143, Statutes of 2021) required the Department of Health Care Services (DHCS) to not retroactively implement rate reductions for clinical laboratory or laboratory services for dates of service January 1, 2020 thru June 30, 2021. DHCS will implement new Erroneous Payment Corrections (EPCs) to undo retroactive recoupments that have been implemented due to overpayments for clinical laboratory or laboratory services for dates of service January 1, 2020, through June 30, 2021.

Additional information regarding these adjustments can be found on the Medi-Cal website:

If you have any questions regarding the rate adjustments, please contact your Provider Relations Representative at 800-700-3874, ext. 5504 or the Claims Department customer service team at 800-700-3874, ext. 5503.

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