MedicaidPrior AuthMedium impact
25-1386m 2026 CalAIM Program Updates: What Medi-Cal Providers Need to Know
Health Net·CA · Family Medicine, Internal Medicine, General Practice +3 more·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Starting January 1, 2026, Medi-Cal CalAIM Community Supports programs will have updated authorization guides, forms, and billing processes. Key changes include modifications to asthma services, housing support coverage limits, and personal care billing now in 15-minute increments using the 'Rule of Eights.'
Action Required
By January 1, 2026: Billing team must access the CalAIM Resources for Provider page for updated authorization guides and forms. Update billing system to process Personal Care and Homemaker Services in 15-minute increments following the 'Rule of Eights.' Review and update authorization forms for asthma preventive services, housing navigation, and tenancy services. Contact CalViva Health at 888-893-1569 for questions or Behavioral Health at 844-966-0298.