Billing Beat

Medi-Cal – Reimbursement Rates

February 2, 2004

California Medi-Cal has established reimbursement rates for services previously listed as “By Report” for dates of service on or after October 1, 2003. Accordingly, the services listed below may now be billed electronically. The maximum reimbursement rates are as follows:

CPT-4 Code Description Rate
86294 Immunoassay, tumor antigen, qual or semiquant $21.69
87338 Helicobacter pylori, stool $15.90
88142 Cytopathology, cervical or vaginal, manual screening under physician supervision $22.40
88143 Cytopathology, cervical or vaginal with manual screening and rescreening under physician supervision $19.60
88356 Morphometricanalysis; nerve $260.38

Note: The maximum reimbursement rate for CPT-4 codes 88144 and 88145 is $21.20. These codes are reimbursable only for dates of service on or before September 22, 2003.

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