Medi-Cal

About Medi-Cal

Every year, California’s hospitals treat millions of patients, many of them covered by Medi-Cal, the state’s health care safety net. This includes numerous essential health care services for Californians, including care for more than 50% of all births, 46% of behavioral health-related emergency department visits, 58% of rural hospital patient care days, 1 million inpatient stays, and nearly 16 million outpatient visits in 2018. CHA is committed to protecting Medi-Cal rates and assuring that the state’s neediest maintain access to the high quality of care that all Californians deserve.

DHCS Updating Payment System for Diagnosis-Related Group Reimbursement

On Sept. 23, the Department of Health Care Services (DHCS) announced it is updating the Medi-Cal payment system for diagnosis-related group (DRG) reimbursement with the newest ICD-10 diagnosis and surgical procedure codes released by the Centers for Medicare & Medicaid Services, effective for dates of service on or after Oct. 1. However, system updates will […]

DHCS Releases Private Hospital-Directed Payment Encounter Files 

On Sept. 9, the Department of Health Care Services (DHCS) uploaded three new hospital-directed payment encounter files, available via the Secure File Transfer Protocol site. It is important for hospitals to download these files as soon as possible, as the site is only intended for file transfers, not ongoing storage, and uploaded files will be […]

State Budget Takes a Wide Variety of Health Care-Related Actions 

In June 2022, the Legislature and governor approved a $308 billion budget for the state fiscal year spanning from July 2022 through June 2023. In late August, the Legislature passed and the governor is expected to approve revisions to the 2022-23 Budget Act, which generally redirect, build upon, or provide statutory parameters around actions previously […]

DHCS Adds New COVID-19-Related Codes to the Diagnosis-Related Group Methodology, Retroactively to April 1

The Department of Health Care Services (DHCS) recently announced the incorporation of new Centers for Medicare & Medicaid Services-approved ICD-10-CM and ICD-10-PCS codes related to COVID-19 into the diagnosis-related group inpatient hospital payment methodology, retroactively to April 1.    The following diagnosis and procedure codes will now be reflected in the methodology of determining a hospital’s […]