MedicaidCoverageMedium impact
23-1097 No Wrong Door for Mental Health Services Policy Ensures Coordinated Care
Health Net·CA · Psychiatry, Family Medicine, Internal Medicine +1 more·Pharmacy
Effective date
Mar 30, 2022
We identified it
Jun 20, 2026
Summary
CalViva Health's 'No Wrong Door' policy allows Medi-Cal members to receive mental health services from any provider without interruption, even during transitions between delivery systems. Providers can be reimbursed for mental health assessments and services regardless of whether the member is later transferred to a different mental health delivery system.
Action Required
Immediately: Billing team should review mental health service billing procedures to ensure proper reimbursement claims for non-specialty mental health services (NSMHS) including evaluations, therapy, psychiatric consultation, and medication monitoring for Medi-Cal members. Contact CalViva Health at 888-893-1569 with questions about coordinated care billing when members receive services from multiple delivery systems.