Addendum__1_4440-2564009000.pdf
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- 0000035549
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- California
About this file
This document is Addendum #1 for Invitation for Bid (IFB) #25-64005-000 issued by the California Department of State Hospitals - Coalinga, located in Coalinga, California. The addendum pertains to Prosthetics, Orthotic, and Pedorthic Services and provides corrections and clarifications to the original bid documents. Specifically, the addendum modifies references to Medi-Cal Maximum on pages 20 and 40 of the original IFB, changing them to "Medicare Allowable/Medi-Cal Maximum" to ensure clarity in compensation methodology.
The addendum outlines the compensation structure for ancillary services, which will be calculated using the current Medicare Durable Equipment Prosthetics Orthotics and Supplies (DMEPOS) Schedule for Hospital County location and Medicare Allowable/Medi-Cal Maximum Basic Rates. Payment will be based on the formula: Medicare Allowable/Medi-Cal Maximum Allowance multiplied by a percentage rate. For CPT codes not found on the Medicare Allowable/Medi-Cal Maximum Fee Schedule, reimbursement will require a written estimate pre-approved by DSH Coalinga's Chief Physician & Surgeon or their designee. The document leaves the specific percentage rate to be determined by the bidder, indicating flexibility in pricing negotiations.
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Other files
| File | Type | Posted |
|---|---|---|
| 4440-2564009000_IFB__5.19.25.pdf | ||
| 4440-2564009000_IFB.pdf |
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Text version
State of California – Department of State Hospitals Gavin Newsom, Governor Department of State Hospitals - Coalinga 24511 W. Jayne Avenue Coalinga, California 93210 www.dsh.ca.gov
“Caring Today for a Safe and Healthy Tomorrow”
Rev. (11/2018)
May 19, 2025
Addendum #1
To: Prospective Bidders
Reference: IFB # 25-64005-000 Prosthetics, Orthotic, and Pedorthic Services
Please see the following questions regarding the IFB:
1. In the IFB where Medi-Cal Maximum is referenced on page 20 (ATTACHMENT 5) it will be changed to Medicare Allowable/ Medi-Cal Maximum.
Correction:
4. Ancillary services performed shall be compensated utilizing the current Medicare Durable Equipment Prosthetics Orthotics and Supplies (DMEPOS) Schedule for Hospital County location (CA NR) and Medicare Allowable/Medi-Cal Maximum Basic Rates, based on the assignment of Current Procedural Terminology (CPT) code(s) and/or a Healthcare Common Procedure Coding System (HCPCS) code(s) for each service performed and multiplied by not more than TBD%.
5. Payment for all services rendered shall be based on the following formula:
Medicare Allowable/Medi-Cal Maximum Allowance x Percentage Rate =
Amount Paid
IN ACCORDANCE WITH THE ABOVE INSTRUCTIONS, THE PERCENTAGE OF THE
MEDICARE ALLOWABLE/MEDI-CAL MAXIMUM ALLOWANCE CHARGED DSH-
COALINGA, PER ITEMIZED CPT CODE, FOR PROSTHETIC AND ORTHOTIC
SERVICES IS:
6. CPT Codes not on the Medicare Allowable/Medi-Cal Maximum Fee Schedule shall be reimbursed at written estimate rate pre-approved by DSH Coalinga’s Chief Physician & Surgeon, or Designee.
http://www.dsh.ca.gov/
State of California – Department of State Hospitals Gavin Newsom, Governor Department of State Hospitals - Coalinga 24511 W. Jayne Avenue Coalinga, California 93210 www.dsh.ca.gov
“Caring Today for a Safe and Healthy Tomorrow”
Rev. (11/2018)
2. In the IFB where Medi-Cal Maximum is referenced on page 40 (Budget Details) it will be changed to Medicare Allowable/ Medi-Cal Maximum.
Correction:
A. Ancillary services performed shall be compensated utilizing the current Medicare Durable Equipment Prosthetics Orthotics and Supplies (DMEPOS) Schedule for Hospital County location (CA NR) and Medicare Allowable/Medi-Cal Maximum Basic Rates, based on the assignment of Current Procedural Terminology (CPT) code(s) and/or a Healthcare Common Procedure Coding System (HCPCS) code(s) for each service performed and multiplied by not more than TBD%.
B. Payment for all services rendered shall be based on the following formula:
Medicare Allowable/Medi-Cal Maximum Allowance x Percentage Rate = Amount Paid
IN ACCORDANCE WITH THE ABOVE INSTRUCTIONS, THE PERCENTAGE OF THE
MEDICARE ALLOWABLE/MEDI-CAL MAXIMUM ALLOWANCE CHARGED DSH-
COALINGA, PER ITEMIZED CPT CODE, FOR PROSTHETIC AND ORTHOTIC
SERVICES IS:
C. CPT Codes not on the Medicare Allowable/Medi-Cal Maximum Fee Schedule shall be reimbursed at written estimate rate pre-approved by DSH Coalinga’s Chief Physician & Surgeon, or Designee.
Sherry Clark Contract Analyst Department of State Hospitals – Coalinga, Procurement Department Email: sherry.clark@dsh.ca.gov Phone: (559) 935-7231 Fax: (559) 935-7319 http://www.dsh.ca.gov/ mailto:sherry.clark@dsh.ca.gov
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