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MedicaidReimbursementLow impact

25-542 TRI Fee-for-Service Payments Are Now Applied to New Claims

Health Net·CA·Reimbursement
Effective date
May 31, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net is now paying Targeted Rate Increase (TRI) fee-for-service payments through new day claims rather than retroactive adjustments, effective May 31, 2025. This changes how TRI payments are processed for Medi-Cal services but does not require changes to billing practices.

Action Required

Action needed
No immediate action required: This is an informational change about how Health Net processes TRI payments. Billing team should be aware that TRI payments will now appear as new day claims rather than adjustments to previous claims. Continue billing normally for covered services.