25-542 TRI Fee-for-Service Payments Are Now Applied to New Claims
Date: 05/30/25
Payments began on May 31, 2025.
Health Net is paying Targeted Rate Increase (TRI) fee-for-service (FFS) payments via new day claims instead of retroactive adjustments.
As a reminder, health plans had until December 31, 2024, to retroactively implement rate increases for FFS claims for dates of service on or after January 1, 2024. On October 22, 2024, Health Net started making retroactive adjustments going back to January 1, 2024. Effective on or about May 31, 2025, TRI payments will be paid using new day claims.
Online resources
The Plan offers resources you can use to educate staff and help ensure compliance. Go to Health Net webpage > Providers > 2024 DHCS Targeted Rate Increase for Select Medi-Cal Services > Get Resources. You can also visit the links below.
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Additional information
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by telephone at 800-675-6110 or through the Health Net provider portal. Behavioral health providers can call 844-966-0298.
This information applies to Physicians, Doulas, and Behavioral Health Providers.
For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Los Angeles, Molina, Mono, Sacramento, San Joaquin, Stanislaus, Tulare and Tuolumne counties.