MedicaidCoverageMedium impact
23-266 Help Improve Patient Health Outcomes Through Community Health Worker (CHW) Services
Health Net·CA·Prior Authorization
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal now covers Community Health Worker (CHW) services as preventive care benefits, effective July 1, 2022. A written physician recommendation is required for CHW services, which include health education, navigation, screening, and individual support for members with chronic conditions or barriers to care.
Action Required
Immediately: Billing team should identify if practice wants to become a CHW supervising provider by obtaining NPI, ensuring ability to receive CHW referrals, and submitting claims using CPT codes outlined in Medi-Cal Provider Manual. Providers can begin writing recommendations for eligible Medi-Cal patients for CHW services. Contact Health Net at 800-675-6110 for specific billing procedures and CHW supervising provider enrollment steps.