The director annually shall review the reimbursement levels for physician and dental services under Medi-Cal, and shall revise periodically the rates of reimbursement to physicians and dentists to ensure the reasonable access of Medi-Cal beneficiaries to physician and dental services.
This annual review, as it relates to rates for physician services, shall take into account at least the following factors:
(a) Annual cost increases for physicians as reflected by the Consumer Price Index.
(b) Physician reimbursement levels of medicare, Blue Shield, and other third-party payors.
(c) Prevailing customary physician charges within the state and in various geographical areas.
(d) Procedures reflected by the current Relative Value Studies (RVS).
(e) Characteristics of the current population of Medi-Cal beneficiaries and the medical services needed.
(Amended by Stats. 1992, Ch. 713, Sec. 54. Effective September 15, 1992.)
Last modified: October 25, 2018