Filing · f0117
Medi-Cal Fee-for-Service (medical and behavioral health)
California DHCS · Medicaid FFS · CA · CY2025
In 2025 this plan received 78,987 standard prior authorization requests and denied 28.4% of them. The median for Medicaid FFS plans of comparable size is 8.3%. One check flagged this filing.
Standard denial rate
28.4%
78,987 standard requests, 22,404 denied.
7.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 78,987 | 55,741 | 22,404 | 28.4% |
| Expedited | — | — | — | — |
| Extended review, approved | 774 | |||
Appeals of standard denials
| Appeals filed | 43 |
| Denials overturned | 3 |
| Overturn rate | 7.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | — | — |
What the checks found
warnstd_headline_excludes_extended
headline approved/denied cover 78,145 of 78,987; the 842 balance is reported separately as extended review, so the published percentages understate the full population