October 14, 2019
Area(s) of Interest: Payor Issues and Reimbursement
The supplemental Medi-Cal payments – made possible by the Proposition 56 tobacco tax funding – increase payments on 23 CPT codes. While there is no additional action required by providers who are reimbursed on a fee-for-service basis, physicians with capitated contracts must submit encounter data to the payor in order to receive the supplemental funds. Without the encounter data, the plan or its delegated entity will be unable to determine the services eligible for payment, which will result in non-payment of the supplemental funds.
To learn more about the supplemental payments, including how to ensure you’re getting your fair share, the California Medical Association (CMA) is hosting a one-hour webinar—Proposition 56 funds: What’s new for FY 19-20 and beyond—on Wednesday, December 4, at 12:15 p.m.
The webinar will discuss the services eligible for FY 19-20 supplemental payments, payment amounts, tips on ensuring your practice receives the full amount of eligible funds and the distribution timelines. Presenters will also discuss the new funding for the value-based payment program, and developmental and trauma screenings.
Registration is free for CMA members and their staff ($99 for nonmembers).