CommercialReimbursementMedium impact
25-038 Progress Update to Resolve Underpaid Claims
Health Net·CA · Psychiatry·Reimbursement
Effective date
Sep 1, 2024
We identified it
Jun 20, 2026
Summary
HealthNet California has identified an underpayment issue affecting behavioral health claims using telehealth Place of Service code 02 (patient not at home) for dates of service September 1, 2024 and after. The insurer is making manual adjustments now and plans a system fix by February 2025.
Action Required
Immediately: Billing teams should review all behavioral health telehealth claims with POS code 02 for dates of service September 1, 2024 and after to identify potential underpayments. Contact Behavioral Health Provider Services at 844-966-0298 for questions or to report underpaid claims. Monitor reprocessing of affected claims through February 2025 when permanent system fix is implemented.