MedicaidCoverageHigh impact
26-585 Updated Youth Trauma Screening Requirements
Health Net·CA · Psychiatry, Pediatrics, Family Medicine·Reimbursement
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Effective April 1, 2026, Medi-Cal restricts which trauma screening tools can be used for youth under 21 and which qualify for reimbursement. Only specific DHCS-approved tools may be used for SMHS access screening, and only ACEs questionnaire or PEARLS qualify for Medi-Cal reimbursement under ACEs screening services.
Action Required
Immediately: Review all current trauma screening tools used with Medi-Cal members under 21. Billing team must ensure only DHCS-approved tools (ACEs, PEARLS, CANS, IP-CANS, CATS, CPSS-5-Screen, CTS, LEC-5, UCLA PTSD RI-5 BF) are used for SMHS access. When billing for ACEs screening services, use ONLY ACEs questionnaire or PEARLS - all other tools will not qualify for reimbursement. Update workflows and ensure documentation clearly identifies the screening tool used and purpose. Using non-approved tools may affect service access decisions or payments.