White Papers

California Medi-Cal to Pay for Interpretation of InSitu Hybridization (FISH)

Effective 4/1/2018, Medi-Cal is adding ISH code 88365 to their fee schedule.  This addition fills a glaring gap in a fee schedule that prices all other ISH family codes.  The following CPT service codes can be split billed with the global reimbursement rates as follows:

88364 INSITU HYBRIDIZATION (FISH) $87.58
88366 INSITU HYBRIDIZATION (FISH) $133.38
88367 INSITU HYBRIDIZATION AUTO $96.64
88368 INSITU HYBRIDIZATION MANUAL $75.41
88369 M/PHMTRC ALYSISHQUANT/SEMIQ $65.87
88373 M/PHMTRC ALYSISHQUANT/SEMIQ $54.01
88374 M/PHMTRC ALYSISHQUANT/SEMIQ $185.00
88377 M/PHMTRC ALYSISHQUANT/SEMIQ $192.08

The payment rate for 88365 is not yet known.  Medi-Cal updates its fee schedules on the 15th of each month, with effective dates of the first of the month.  The updates are then published on the Medi-Cal website on the 16th.  APS will continue to monitor any and all changes to payment and reimbursement policies for Medi-Cal and all payors.  If you have any additional questions, please contact your Practice Manager.

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