What Is the California Medical Malpractice Damages Cap?

MICRA, and what changed in 2023

The Medical Injury Compensation Reform Act of 1975, known as MICRA, capped non-economic damages against health care providers at a fixed $250,000. AB 35 (Stats. 2022, ch. 17), approved by the Governor on May 23, 2022, replaced that cap for cases filed, or arbitrations demanded, on or after January 1, 2023. AB 35:

• replaced the single $250,000 cap with rising limits, separate for injury and wrongful death;
• created up to three separate limits based on the type of defendant;
• tied the limits on lawyers’ fees to the stage the case has reached;
• raised the threshold for paying future damages in installments from $50,000 to $250,000; and
• made a provider’s expressions of sympathy, regret, or fault inadmissible.

The cap, year by year

Civil Code § 3333.2 sets the 2023 amounts and raises them each January 1 for ten years: by $40,000 in injury cases and by $50,000 in wrongful-death cases. From January 1, 2034, both limits are adjusted for inflation by 2 percent each January 1. Each figure applies per category of defendant, explained in the next section. The figures below follow from the statute’s schedule, injury first and wrongful death second:

• 2023: $350,000 and $500,000
• 2024: $390,000 and $550,000
• 2025: $430,000 and $600,000
• 2026: $470,000 and $650,000
• 2027: $510,000 and $700,000
• 2028: $550,000 and $750,000
• 2029: $590,000 and $800,000
• 2030: $630,000 and $850,000
• 2031: $670,000 and $900,000
• 2032: $710,000 and $950,000
• 2033: $750,000 and $1,000,000

Up to three separate caps

The statute applies each limit to a category of defendants “collectively,” however many defendants are in it, and provides “three separate limits of liability that may apply.” No defendant can be placed in more than one category, and whether a defendant is “unaffiliated” is decided as of the time of the negligence, so ownership, employment, and contracts need to be identified early. If all three categories apply, the combined maximum is three times the year’s figure. The categories:

• Health care providers: licensed professionals such as physicians and nurses, licensed clinics, and a provider’s employer, professional corporation, or partnership.
• Health care institutions: licensed health facilities, such as hospitals, owned or operated by the same entity or its affiliates, including people and entities for whom they are vicariously liable.
• Unaffiliated providers or institutions: defendants not affiliated with those in the first two categories, whose separate negligence occurred at, or in medical transport to, a different, unaffiliated facility.

Which year’s cap applies

The statute applies the dollar amount “in effect at the time of judgment, arbitration award, or settlement.” The date of the malpractice does not set the figure. An injury case filed in 2025 that settles in 2027, for example, is subject to the 2027 limit of $510,000 per category.

The rising limits apply only to cases filed, or arbitrations demanded, on or after January 1, 2023. A case filed earlier generally remains under the old $250,000 limit.

What the cap does not limit

The cap is narrower than many people assume. It does not reach:

• Economic damages. The statute limits only “noneconomic losses”: pain, suffering, inconvenience, physical impairment, disfigurement, and other nonpecuniary damage. Past and future medical care, lost earnings, lost earning capacity, and other financial losses are not capped.
• Claims that are not professional negligence. The cap applies to actions “based on professional negligence,” meaning negligence by a health care provider in rendering professional services within the scope of its license. Claims that rest on something else, such as a nursing facility’s custodial neglect (see below), can fall outside it.
• Punitive damages. Section 3333.2 does not address them. In a professional-negligence case, however, a punitive-damages claim can be added only with a court order, on a showing of a substantial probability of prevailing, and the motion must be filed within two years after the complaint or at least nine months before the first trial date, whichever is earlier (Code of Civil Procedure § 425.13).

Other MICRA rules that affect the recovery

Several other rules from the same body of law change what a malpractice recovery looks like:

• Insurance benefits: the defense may tell the jury about benefits such as health insurance or disability payments, and those sources then cannot recover from you or step into your claim (Civil Code § 3333.1).
• Installment payments: at either party’s request, the court must order that an award of $250,000 or more in future damages be paid in whole or in part over time (Code of Civil Procedure § 667.7).
• Arbitration: a provider’s arbitration agreement must use specific warning language (Code of Civil Procedure § 1295), and the cap applies to arbitration awards too.
• Apologies: a provider’s statements, writings, or gestures expressing sympathy or regret, or suggesting, reflecting, or accepting fault, made to the patient or family before a lawsuit or arbitration demand, are confidential and cannot be used as evidence of liability or for any other purpose (Health and Safety Code § 104340). The claim still turns on the records and on review by qualified medical witnesses.

Limits on the lawyer’s fee

Business and Professions Code § 6146 caps contingency fees in claims against health care providers for professional negligence. “Recovered” means the net sum after deducting the costs of prosecuting or settling the claim, and the fee agreement must state that these rates are maximums and that a lower rate can be negotiated (§ 6147(a)(5)). The limits:

• 25 percent of the amount recovered if the claim settles before a lawsuit or arbitration demand is filed;
• 33 percent if it is resolved after filing; and
• more only if a court or arbitrator approves it, for good cause, on a motion after the case is tried or arbitrated.

Deadlines to bring a claim

The cap matters only if the claim is filed in time. The firm’s guide to the medical malpractice filing deadline, linked below, explains these rules in more detail:

• One year from discovery, three years at most. A lawsuit must generally be filed by the earlier of three years after the injury or one year after you discovered it, or reasonably should have (Code of Civil Procedure § 340.5). The three-year limit is extended only for fraud, intentional concealment, or a foreign object with no therapeutic or diagnostic purpose, and children’s claims follow separate rules.
• 90 days’ notice. You must give the provider at least 90 days’ written notice before suing. Notice served within the last 90 days before the deadline extends the time to sue by 90 days from service (Code of Civil Procedure § 364).
• Six months for public providers. A claim against a public hospital or clinic generally requires a written government claim within six months (Government Code § 911.2).

Nursing home neglect, elder abuse, and the cap

A claim against a health care provider based on its professional negligence follows the malpractice rules even when it is brought under the Elder Abuse Act (Welfare and Institutions Code § 15657.2). Neglect of custodial duties is different. On July 22, 2026, in Aud v. RRT Enterprises, LP, the Court of Appeal held, in the published part of its opinion, that MICRA’s cap did not limit a jury’s non-economic award against a skilled nursing facility, because the resident’s claims arose from the facility’s acts and omissions as her custodian and caregiver, not as her health care provider: falls after inadequate supervision, pressure ulcers, and inadequate food and water.

A recent opinion can be affected by further review, so its status should be checked before relying on it. When recklessness, oppression, fraud, or malice is proven, the Elder Abuse Act also provides for attorney’s fees and costs (Welfare and Institutions Code § 15657). The firm’s guide to bedsores and nursing home neglect, linked below, covers those claims.