Targeted Provider Rate Increases Minimum Fee Schedule
Back to: Directed Payments
Pursuant to Welfare & Institutions Code Section 14105.201 (added by AB 118) DHCS developed primary care, obstetric, and non-specialty mental health services targeted provider rate increases for providers in Medi-Cal effective for dates of service on or after January 1, 2024. These rate increase will apply to eligible providers in the Fee-For-Service delivery system, as well as eligible network providers contracted with Medi-Cal managed care plans through a minimum fee schedule directed payment. DHCS increased rates, as applicable, for targeted services to no less than 87.5% of the Medicare rate, inclusive of eliminating AB 97 provider payment reductions and incorporating applicable Proposition 56 supplemental payments into the base rate. DHCS calculated an equivalent rate increase for services that do not have a rate established by Medicare. DHCS received federal approval of the 2024 targeted rate increase in State Plan Amendment (SPA) 23-0035.
Per 42 CFR 438.6, minimum fee schedules approved by the State Plan Amendment (SPA) no longer require preprint approval; therefore, DHCS will no longer be requesting directed payment authority from CMS on an annual basis outside of the SPA process.
Questions or comments can be submitted to the Targeted Rate Increases email box:
TargetedRateIncreases@dhcs.ca.gov.
Resources
DHCS hosted a webinar on December 19, 2023, to discuss targeted rate increases effective for dates of service on or after January 1, 2024. Please see the presentation materials, linked below, for additional information relevant to providers. DHCS will create an FAQ based on the questions and topics covered during the webinar.
