MedicaidCoverageMedium impact
24-1292m Expanded Definition of Psychiatric Emergency Medical Condition
Health Net·CA · Emergency Medicine, Psychiatry·Provider News
We identified it
Jun 20, 2026
Summary
Assembly Bill 1316 expands the definition of psychiatric emergency medical condition to include patients who are voluntarily or involuntarily detained, covering emergency services for mental health disorders that make patients dangerous to themselves/others or unable to provide for basic needs. This broadens coverage for psychiatric emergency services regardless of detention status.
Action Required
Immediately: Billing team should review psychiatric emergency service claims to ensure coverage applies regardless of voluntary or involuntary detention status. Update claim submission processes to reflect expanded coverage criteria for mental health emergency conditions. Contact CalViva Health at 888-893-1569 for questions or behavioral health providers can call 844-966-0298.