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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).

Contact Information

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

Last modified on: 3/20/2014 2:27 PM