California Medi-Cal Rates: What Providers Need to Know

California’s Medicaid program — Medi-Cal — is administered by the Department of Health Care Services (DHCS), with a rates hub at dhcs.ca.gov that links out to a separate Rates Explorer portal, rather than hosting a single downloadable fee schedule directly.

What’s currently published

Current published rates tracked by MedicaidBench, effective 2024-01-01:

• 90791 (initial psychiatric diagnostic evaluation): $163.08 per encounter
• 90837 (individual psychotherapy, ~60 min): $131.97 per session
• 99213 (established-patient office visit): $82.02 per visit
• 99214 (moderate-complexity office visit): $115.88

These figures reflect a 2024 effective date at time of writing — worth checking directly for any more recent update given California’s program size and the pace of Medi-Cal policy activity.

Format and access

Medi-Cal’s rate information is more fragmented across programs than many states, with the Rates Explorer portal serving as the primary lookup tool rather than a single static file you can download and diff against a prior version. This portal-first approach is common among larger, more programmatically complex Medicaid systems, but it does mean automated tracking requires a different approach than simply watching one file for changes.

What to watch for

California’s size and program complexity mean rate changes can be scoped narrowly — to a specific population, provider type, or delivery system — rather than applying uniformly across the whole program. A rate change notice that looks state-wide at first glance may in practice apply only to a specific Medi-Cal managed care population or FFS carve-out.

Keeping current

Because Medi-Cal’s primary public interface is a portal rather than a versioned document, “checking for changes” means periodically re-querying the portal rather than comparing two file versions — a meaningfully different (and more labor-intensive) manual process than states with downloadable spreadsheets. MedicaidBench tracks Medi-Cal’s published FFS rates continuously so this comparison doesn’t need to be re-run by hand.