MedicaidCoverageMedium impact
24-1291m Expanded Definition of Psychiatric Emergency Medical Condition
Health Net·CA · Psychiatry, Emergency Medicine·Provider News
We identified it
Jun 20, 2026
Summary
Health Net expanded the definition of psychiatric emergency medical condition under Assembly Bill 1316 to cover emergency psychiatric services regardless of whether the patient is voluntarily or involuntarily detained. The new definition includes patients who are an immediate danger to themselves/others or immediately unable to provide for basic needs due to mental health disorders.
Action Required
Immediately: Billing team should review current psychiatric emergency billing practices to ensure coverage is being applied correctly for both voluntary and involuntary psychiatric patients. Contact Health Net Provider Services at 844-966-0298 for behavioral health questions if clarification is needed on specific billing scenarios.