Medi-Cal Rates

DHCS posted the final 2014-15 Medi-Cal reimbursement rates for skilled nursing and subacute providers today.

• To view your rates, click here
• These rates are effective retroactively to August 1, 2014. DHCS has indicated that it will take 60-90 days to update the Medi-Cal claims system to begin paying at these rates.
• All claims paid at the previous rate will be reprocessed for retroactive rate adjustment, six to nine months after the rate information is updated in the payment system.
• If your rate went down, overpayments will be recouped through a reduction in check writes by 5% until overpayments are paid back in full.

DHCS has not provided specific instruction to begin billing at the new rates, but will likely do so once the new rates are in the system. However we recommend you start billing at the new rates now, as the system will automatically pay either the amount billed or the rate on file, whichever is less. That way as soon as the rates are updated, your check writes will reflect the new rate. Please contact if you have any questions about this.

QA Fees for 2014-15

On January 14th, DHCS posted notice of an increase in the QA fee assessed for skilled nursing facilities for the rate year August 1, 2014 - July 31, 2015.

• For facilities with less than 100,000 annual resident days, the fee is $16.03 per day
• For facilities with equal to or greater than 100,000 annual resident days, the fee is $15.15 per day.
• For more information, click here

As always, don't hesitate to contact us with any questions.