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MedicaidDocumentationMedium impact

23-1190 Reminder: List Social Determinants of Health Data on Claims or Encounters

Health Net·CA·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net Medi-Cal is reminding providers to include Social Determinants of Health (SDOH) data using specific ICD-10-CM Z-codes on claims and encounters. This supports the CalAIM Population Health Management initiative to identify member health, social, and risk needs for better care coordination.

Action Required

Action needed
Immediately: Providers should assess patients for social determinants of health and document using the 18 specified DHCS priority SDOH Z-codes when applicable. Billing team must ensure these codes are included on Medi-Cal claims and encounters when documented by providers. Update encounter forms or EMR templates to include SDOH screening reminders for providers.

Affected Billing Codes

Z55.0
Z59.0
Z59.1
Z59.3
Z59.4
Z59.7
Z59.8
Z60.2
Z60.4
Z62.819
Z63.0
Z63.4
Z63.5
Z63.6
Z63.72
Z65.1
Z65.2
Z65.8