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MedicaidReimbursementHigh impact

03-13-2026 Revised: Targeted Provider Rate Increases APL 25-012 IE LA SAC SD

Molina Healthcare·CA · Family Medicine, Internal Medicine, General Practice +3 more·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

Molina Healthcare California is implementing revised targeted provider rate increases for Medi-Cal services, requiring providers to be paid the higher of either the TRI Fee Schedule rate or their historical contractual rate. This affects primary care, obstetric care, and non-specialty mental health services for eligible network providers.

Action Required

Action needed
Immediately: Billing team must review historical payment levels for primary care, obstetric, and mental health services and compare with current TRI Fee Schedule rates. Update internal payment systems to ensure reimbursement at the higher of the two rates. Verify that Proposition 56 supplemental payments are properly applied. Contact assigned Molina Provider Relations Representative for questions about rate comparisons.