MedicaidBilling CodesMedium impact
22-194m Help Tailor Services and Programs for At-Risk Members with New Social Determinants of Health Codes
Health Net·CA·Prior Authorization
Effective date
Feb 3, 2022
We identified it
Jun 20, 2026
Summary
Health Net has expanded Social Determinants of Health (SDOH) diagnosis codes from 18 to 25 priority codes for Medi-Cal providers to better identify health disparities and coordinate care. Providers should use these ICD-10-CM codes on claims and encounters to capture patient social risk factors like homelessness, food insecurity, and housing instability.
Action Required
Immediately: Billing team and providers should review the 25 priority SDOH codes and incorporate them into clinical documentation and encounter forms when applicable social determinants are identified during patient visits. Update EMR templates to include these codes for easy selection. Train providers on when to use these codes to support CalAIM Population Health Management initiative data collection.