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.