23-1270m For Family Planning Services, Provider Augmented Reimbursement Now Based on Medi-Cal FFS Rate

Date: 11/06/23

Augmented rate retired on August 15, 2023

The Department of Health Care Services (DHCS) has retired the family planning augmented reimbursement required by All Plan Letters (APLs) 10-003 and
10-014.

• APL 10-003: Augmented Reimbursement for Family Planning Services
• APL 10-014: Correction to All Plan Letter 10-003 Regarding Augmented Reimbursement for Family Planning Services.

The updated reimbursement rate information is as follows:

• Health Net will pay non-contracted providers the appropriate Medi-Cal
  fee-for-service (FFS) base rate plus any applicable Centers for Medicare and Medicaid Services-approved directed payments as outlined in federal regulation (i.e., 2016 Final Rule and Title 42, Code of Federal Regulations section 438.6(c)).
• Delegated entities shall pay non-contracted providers based on the
  Medi-Cal FFS base rate.

Additional information

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by telephone or through the Health Net provider portal.

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.

For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.