← Back to list
24-395m Use the Most Descriptive SDOH Z Codes on Claims and Encounters
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Health Net now requires providers to use the most specific Social Determinants of Health (SDOH) Z codes (Z55-Z65) when documenting patient circumstances on claims and encounters. For categories Z55, Z58, Z59, and Z62, providers must drill down to the most descriptive subcodes rather than using general category codes.
Get alerts when payers change rules like this one
We check Health Net and other payers every day and email you when a change matches your specialty and state.
Get Health Net alertsPolicy Monitoring is free. No card required.
What to do
immediately · 3 steps
01Billing team and providers must update documentation practices to use the most specific SDOH Z codes available.
02For Z55, Z58, Z59, and Z62 categories, drill down to subcodes (e.g., use Z59.12 for inadequate housing utilities instead of Z59.1 for inadequate housing).
03Update EMR templates and provider training to ensure proper code selection for documenting social determinants of health.
Codes mentioned
Z55Z56Z57Z58Z59Z60Z62Z63Z64Z65Z59.12Z59.1
Original notice
24-395m Use the Most Descriptive SDOH Z Codes on Claims and Encounters
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
Related changes
See all Health Net changes →24-397m Use the Most Descriptive SDOH Z Codes on Claims and EncountersMediumNo effective date · Prior Authorization24-396m Use the Most Descriptive SDOH Z Codes on Claims and EncountersMediumNo effective date · Prior Authorization25-1166m Integrating Social Determinants of Health Into Clinical PracticeMediumNo effective date · Reimbursement25-1168m Integrating Social Determinants of Health Into Clinical PracticeMediumNo effective date · ReimbursementBrowse every Health Net change in the policy list