MedicaidReimbursementMedium impact
07-30-2026 60 Day Notice of Enhanced Care Management Rate Change IE LA SAC SD
Molina Healthcare·CA·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Aug 4, 2026
Summary
Molina Healthcare of California is updating Enhanced Care Management (ECM) reimbursement rates effective October 1, 2026, across five regions (Los Angeles, Inland Empire, Sacramento, and San Diego). All ECM service categories (Children, Adults & SPD Children, Justice-Involved) will be reimbursed at $550.00 per enrollee per month with $50.00 per outreach target. Billing teams must update rate tables and fee schedules in their systems before the effective date.
Action Required
By September 30, 2026: Billing and revenue cycle teams must update Molina Healthcare of California fee schedules in billing software to reflect new ECM rates ($550.00 per enrollee per month for all ECM categories). Update rate tables for the following regions and service lines: Sacramento, San Diego, Inland Empire (Riverside, San Bernardino), and Los Angeles. Verify that claims processed on or after October 1, 2026, reflect the updated rates. Contact your assigned Molina Provider Relations Representative if discrepancies are identified. Failure to update rates may result in underpayment or claim processing delays. For questions, contact Jeremy Encarnacion-Morrison at 858-614-1582 or Jeremy.encarnacion-morrison@molinahealthcare.com.