FQHC/RHC Annual Rate Adjustment Correction

October 21, 2021

On October 12, 2021, the Department of Health Care Services (DHCS) posted a bulletin informing Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) of a 1.4 percent rate increase to reflect the current Medicare Economic Index (MEI), effective for dates of service on or after October 1, 2021. These rates were erroneously updated at 1.9 percent and are currently being corrected.

An Erroneous Payment Correction (EPC) will be implemented to reprocess claims with dates of service on or after the effective date of this billing policy, that were appropriately submitted, but erroneously paid based on the previous rate because Medi-Cal had not yet implemented the system changes to support appropriate adjudication. Providers may also elect to use this updated billing policy to correct and resubmit previously denied claims as described in the CIF Submission and Timeliness Instructions section of the Provider Manual.