Recuperative-care pricing feedback closes October 16
Oct 11, 2026 edition · GC-2026-0324 · Published 2026-10-11 · Version 3 · Draft
DHCS seeks October 16 feedback on a draft recuperative-care benchmark. Its $216.86 midpoint is a negotiating reference for the revised service model, with no binding payment floor or ceiling.
What happened
The standalone October pricing resource models a $216.86 per-diem midpoint for T2033 U6 under the service definition effective January 1, 2027. It excludes room and board while accounting for enhanced coordination and supervision. DHCS requests written feedback by October 16 at [email protected], using the subject “Feedback on the Recuperative Care Pricing Resource.” This comment opportunity concerns pricing guidance; it does not make the model a final required reimbursement rate.
The model assumes a ten-member caseload, one supervisor for 4.2 team members, and 0.4 clinical-consultant FTE per ten members. Those assumptions describe the benchmark rather than a universal contractual staffing ratio. Plans and providers may negotiate above or below it or use alternative payment methods. DHCS directs attention to acuity, realistic caseloads, program size, staffing, and geographic cost differences, explaining why one uniform rate may not fit every program. A local comparison should therefore test the modeled inputs before treating the midpoint as adequate for a particular facility.
Scope and timing
- Authority status
- Draft
- Applicability
- Directly applicable
- Audience
- Health systems, Provider networks
- Jurisdiction
- California
- Affected functions
- Finance, Managed Care, Clinical Operations, Compliance
- Responsible owner
- Finance
- Recorded date
- 2026-10-16
- Date type
- comment
Why it matters
The benchmark excludes room and board and supports negotiations. It is neither a required rate nor a floor or ceiling; acuity, staffing, caseload and geography affect actual costs.
Recommended action
Finance and Managed Care should compare the model with local service costs and prepare any desired feedback using the specified subject line. Submission is optional; do not apply the draft midpoint as a mandatory payment rate.
Implementation playbook
- Compare January staffing and service costs with the draft model and prepare optional feedback. Internal target. Finance · Due 2026-10-14
- If commenting, submit feedback with the requested subject line by the agency deadline. Managed Care · Due 2026-10-16
Sources
- Stakeholder News, October 5, 2026Official · California Department of Health Care Services · 2026-10-05 · Source review 2026-10-11
- Community Supports Pricing Resource, Recuperative Care, October 2026Official · California Department of Health Care Services · Source review 2026-10-11
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