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Fees for Public Benefit Program Forms and Information Requests

Provider Type

  • Physicians and Practitioners
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

Providers must not charge Medi-Cal members or their authorized representatives for completing forms or providing information that supports a claim or appeal for eligibility under a public benefit program, as required by California Health & Safety Code Section 123114.

Allowable charges for copies of medical records remain subject to remain subject to California Health & Safety Code Section 123110.

Last Updated: 08/20/2026