MedicaidReimbursementMedium impact
26-338 Behavioral Health Claims Reimbursement Update
Health Net·CA · Psychiatry·Reimbursement
Effective date
May 18, 2026
We identified it
Jun 20, 2026
Summary
Starting May 18, 2026, behavioral health claims reimbursement will be capped at the billed charges submitted on the claim (except for late payment interest). Providers should review their billing practices to ensure charges align with services rendered and contracted rates.
Action Required
Before May 18, 2026: Behavioral health providers must review and update billing practices to ensure billed charges accurately reflect services rendered and align with contracted rates. Update billing procedures to prevent charges from exceeding payment amounts. Review Provider Participation Agreement (PPA) requirements for charge submission guidelines.