MedicaidReimbursementMedium impact
23-1270m For Family Planning Services, Provider Augmented Reimbursement Now Based on Medi-Cal FFS Rate
Health Net·CA · Family Medicine, Internal Medicine, OB-GYN·Reimbursement
Effective date
Aug 15, 2023
We identified it
Jun 20, 2026
Summary
Health Net has retired the augmented reimbursement rate for family planning services effective August 15, 2023. Non-contracted providers will now be paid at the standard Medi-Cal fee-for-service base rate plus any applicable CMS-approved directed payments instead of the higher augmented rate.
Action Required
Immediately: Billing team must update expectations for family planning service reimbursements from Health Net Medi-Cal plans. Adjust financial projections and patient collections policies to reflect lower Medi-Cal FFS base rates instead of previous augmented rates. Contact Health Net Provider Services if questions arise about specific reimbursement amounts.