Effective retroactively for dates of service on or after October 1, 2021, the rates for claims billed with HCPCS code J7304 and modifier U1 is as follows:
Procedure Code with Modifier |
Description |
Rate |
J7304 U1 |
Contraceptive supply, hormone containing patch, each (norelgestromin and ethinyl estradiol transdermal system) |
$40.72 |
Effective retroactively for dates of service on or after October 1, 2021 thru December 31, 2021, the rate for claims billed with HCPCS code J7304 and modifier U2 is as follows:
Procedure Code with Modifier |
Description |
Rate |
J7304 U2 |
Contraceptive supply, hormone containing patch, each (levonorgestrel and ethinyl estradiol transdermal system) |
$58.26 |
Effective retroactively for dates of service on or after January 1, 2022, the rate for claims billed with HCPCS code J7304 and modifier U2 is as follows:
Procedure Code with Modifier |
Description |
Rate |
J7304 U2 |
Contraceptive supply, hormone containing patch, each (levonorgestrel and ethinyl estradiol transdermal system) |
$55.40 |
Providers should refer to the Medi-Cal Rates page on the Medi-Cal website for other general rates information.
Note: Rates of services billed with modifiers are not included in the Medi-Cal Rates page.
No action is required of providers. An Erroneous Payment Correction (EPC) will be implemented to reprocess the affected claims on or after the implementation date of the updated reimbursement rate. Providers may also elect to correct and resubmit previously denied claims as described in the CIF Submission and Timeliness Instructions section of the Medi-Cal Provider Manual.