PPS Rate Elimination for Undocumented Patient Services (Effective Oct 2026)
FQHC Prospective Payment System rates — averaging $200-400/visit — will be replaced by lower Medi-Cal Fee Schedule rates for services to undocumented individuals. This represents a 50-70% per-encounter revenue cut for these patients. FQHCs with large undocumented populations face severe revenue shortfalls.
Key takeaways
- PPS rates ($200-400/visit) replaced by lower Medi-Cal Fee Schedule for undocumented services
- Represents a 50-70% per-encounter revenue cut for these patients
- Effective October 1, 2026 — FQHCs with large undocumented populations face severe shortfalls
Primary source
CA DHCSAffected FQHCs
FQHC Talent. (2026, October 1). PPS Rate Elimination for Undocumented Patient Services (Effective Oct 2026). Primary source: CA DHCS. Retrieved April 28, 2026, from https://www.fqhctalent.com/intel/pps-elimination-undocumented
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