CommercialReimbursementMedium impact
25-036 Progress Update to Resolve Underpaid Claims
Health Net·CA · Psychiatry·Reimbursement
We identified it
Jun 20, 2026
Summary
HealthNet California has identified an underpayment issue affecting behavioral health claims priced based on Medicare Allowable with POS code 02 (telehealth not at home) from September 1, 2024 forward. They are making manual adjustments now and will implement a system fix by February 2025.
Action Required
Immediately: Review all behavioral health claims with POS code 02 (telehealth for patients not at home) for Employer Group HMO/PPO and Medi-Cal with dates of service September 1, 2024 and after to identify potential underpayments. Contact Behavioral Health Provider Services at 844-966-0298 for questions about underpaid claims. Monitor for manual adjustments from HealthNet until February 2025 system update is complete.