MedicaidPrior AuthMedium impact
25-1388m 2026 CalAIM Program Updates: What Medi-Cal Providers Need to Know
Health Net·CA · Family Medicine, Internal Medicine, Pediatrics +2 more·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
CalAIM Community Supports programs are implementing major changes to authorization processes, billing requirements, and coverage limitations effective January 1, 2026. Key changes include updated forms and processes for asthma services, housing support coverage limits, and Personal Care and Homemaker Services now billing in 15-minute increments using the 'Rule of Eights.'
Action Required
By January 1, 2026: Providers serving Medi-Cal members must access updated CalAIM authorization guides and forms from the Health Net provider portal. Billing team must update system to bill Personal Care and Homemaker Services in 15-minute increments following the 'Rule of Eights.' Update housing deposit authorization limits to maximum one month's rent (two months for small landlords) with $6,000 lifetime maximum. Review and implement new Asthma Preventive Services authorization forms for additional units.