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Funding & Budget

DHCS draft limits which outreach costs count toward Medi-Cal clinic rates

California (statewide)More from California

Issue

California's state-only Medi-Cal coverageTaking effect

Next: · Affected immigrants must update their immigration information with Medi-Cal

DHCS released draft guidance on August 7, 2026 that would limit which clinic outreach costs count toward Medi-Cal PPS rates starting October 6. It names enrollment help by clinic or contracted staff among 12 examples of excluded activities, while referring uninsured patients to outside enrollment help counts.

The guidance is a draft, and written comments closed August 21.

Key points

  • DHCS set a stakeholder webinar for September 16, 2026, from 4:00 to 5:00 p.m., as the last input channel before October 6.
  • The PPS rate is built from allowable costs, so an excluded cost lowers the per-visit rate going forward.
  • The draft restricts which outreach costs count, gives no dollar figure and describes both example lists as non-exhaustive.
  • The timing matters: outreach and eligibility work is about to increase sharply ahead of the January 1, 2027 community-engagement requirement.

Sources for this story

California Department of Health Care Services, Provider Rates Division: public notice "FQHC/RHC Outreach & Education PPS Reimbursement Guidance" (released August 7, 2026), with the draft FQHC/RHC outreach reimbursement policy

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Cite this analysis

FQHC Talent. (2026, September 9). DHCS draft limits which outreach costs count toward Medi-Cal clinic rates. Source: California Department of Health Care Services, Provider Rates Division: public notice "FQHC/RHC Outreach & Education PPS Reimbursement Guidance" (released August 7, 2026), with the draft FQHC/RHC outreach reimbursement policy. Retrieved November 11, 2026, from https://www.fqhctalent.com/intel/dhcs-outreach-education-cost-allowability-pps-guidance-october-2026