Non-Contract Hospital Recoupment
Medi-Cal payments made for California inpatient hospital services may be subject to the Peer Grouping Inpatient Reimbursement Limitation (PIRL). This limits payment on a per discharge basis to the lower of customary charges, allowable costs determined by the Department in accordance with applicable Medicare standards and principles of cost based reimbursement, All-inclusive Rate Per Discharge Limitation (ARPDL), or Peer Grouping Rate Per Discharge Limitation (PGRPDL).
Department of Health Care Services
1501 Capitol Avenue, MS 4518
P.O. Box 997436
Sacramento, CA 95899-7419
Phone: (916) 552-9113
FAX: (916) 552-8651