Back to dashboard
MedicaidReimbursementHigh impact

Provider Bulletin 10-23-2025 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 implements Targeted Provider Rate Increases (TRI) for Medi-Cal services, ensuring providers receive the higher of either the new TRI Fee Schedule rate or their historical contractual rate. This affects primary care, obstetric care, and non-specialty mental health services with rates set at 87.5% of Medicare locality rates.

Action Required

Action needed
Immediately: Billing team must review historical payment levels for all Medi-Cal services and compare with current TRI Fee Schedule rates. Update internal payment systems to ensure providers receive the greater of TRI Fee Schedule rate or historical contractual rate, inclusive of Proposition 56 supplemental funding. Verify compliance documentation is available for DHCS review upon request.