Preparing for the 2027 Medi-Cal Fee-for-Service Transition
Upcoming Coverage Transition for Members with Unsatisfactory Immigration Status (UIS)
Members with Unsatisfactory Immigration Status (UIS) will transition from CenCal Health-administered Medi-Cal coverage to Medi-Cal Fee-for-Service (FFS) coverage administered directly by the California Department of Health Care Services (DHCS).
CenCal Health is working closely with DHCS and will continue to provide timely updates, operational guidance, and resources to help providers prepare for this transition.
Actions Providers Should Take Now
To ensure continued reimbursement for services provided on or after January 1, 2027, providers serving members transitioning to Medi-Cal FFS should:
Providers must be enrolled through the DHCS Provider Application and Validation for Enrollment (PAVE) system to bill Medi-Cal Fee-for-Service.
PAVE Enrollment InformationProviders are encouraged to familiarize themselves with Medi-Cal FFS billing processes, including:
- Claims submission requirements
- Reimbursement methodologies
- Rates and payment policies
- Treatment Authorization Request (TAR) processes
Under Medi-Cal FFS, authorizations and reimbursement decisions will be administered by the State rather than CenCal Health.
Medi-Cal FFS Billing InformationPlease note that:
- Enhanced Care Management (ECM) is not covered under Medi-Cal FFS.
- Community Supports (CS) are not covered under Medi-Cal FFS.
However, eligible providers may continue to bill for covered services permitted under Medi-Cal FFS policy, including:
- Care management
- Care coordination
- Case management
- Community health worker services
- Other eligible related services
Stay Informed
CenCal Health encourages providers to monitor the following resources for updates and implementation guidance. New links can be added to these collections as guidance becomes available.
CenCal Health Resources
CenCal Health Policy PulseQuestions?
CenCal Health remains committed to supporting providers and maintaining clear, timely communication throughout this transition.