Laboratory Chemistry Procedures Update
January 3, 2007Effective for dates of service on or after January 01, 2007, the California Department of Health Services (CDHS) is updating the maximum reimbursement amounts for laboratory chemistry procedures. These rates are as follows:
| Description | Rate |
| 1 – 2 clinical chemistry tests | $5.82 |
| 3 clinical chemistry tests | $7.43 |
| 4 clinical chemistry tests | $7.84 |
| 5 clinical chemistry tests | $8.74 |
| 6 clinical chemistry tests | $8.77 |
| 7 clinical chemistry tests | $9.14 |
| 8 clinical chemistry tests | $9.46 |
| 9 – 10 clinical chemistry tests | $9.70 |
| 11 clinical chemistry tests | $9.87 |
| 12 clinical chemistry tests | $10.10 |
| 13 – 16 clinical chemistry tests | $11.82 |
| 17 – 18 clinical chemistry tests | $11.90 |
| 19 clinical chemistry tests | $12.36 |
| 20 clinical chemistry tests | $12.76 |
| 21 clinical chemistry tests | $13.16 |
| 22 clinical chemistry tests | $13.56 |
To comply with Welfare and Institutions Code, Section 14105.22, the Medi-Cal maximum reimbursement rates for clinical laboratory or laboratory procedures must be no higher than 80 percent of the average of the Medicare rates allowed by National Heritage Insurance Company (NHIC)-North and NHIC-South.
Information about individual laboratory procedure reimbursement rates for the CPT-4 code 80000 series and HCPCS codes S3620 and S3820 can be found on the Medi-Cal Web site.