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Directed Payments Physicians

This program provides supplemental reimbursement for eligible physician services provided to Medi-Cal beneficiaries. The supplemental reimbursements will be provided, above the base rates, for qualified physician services rendered between July 1, 2017 and June 30, 2018. The base rates for physician services will remain unchanged through this amendment.

 

The Department implemented supplemental payments for physician services in both Medi-Cal Fee-for-service (FFS) and Medi-Cal managed care delivery systems. Providers who are eligible to provide and bill for the following Current Procedural Terminology (CPT) codes will receive the associated supplemental payment identified, in addition to whatever other payment they received from the State in FFS or from the health plan as a network provider in managed care:

 

CPT Code
Supplement Amount
90863
$5.00
99201, 99211
$10.00
99202, 99212, 99213
$15.00
99203, 99204, 99214, 99215
$25.00
90791, 90792
$35.00
99205
$50.00
 

 

Last modified date: 2/14/2019 11:52 AM