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MedicaidReimbursementLow impact

22-821m Stay Current with OMB Rates for American Indian Health Programs

Health Net·CA·Prior Authorization
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health updated reimbursement rates for American Indian Health Service programs effective January 1, 2022. New OMB encounter rates are $640 for non-dual Medi-Cal beneficiaries and $495.87 for dual-eligible beneficiaries.

Action Required

Action needed
Immediately: Billing team should verify current OMB encounter rates for American Indian Health Service programs in billing system. Update rates to $640 for non-dual Medi-Cal beneficiaries and $495.87 for dual-eligible beneficiaries. Contact CalViva Health at 888-893-1569 with questions about IHS program billing.