MedicaidAdministrativeMedium impact
22-039m HEDIS Monthly Care Gap Report Adds Member COVID-19 Vaccine Records
Health Net·CA · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal has added COVID-19 vaccine records to their monthly HEDIS Care Gap Report to help providers identify unvaccinated members over 5 years old. Providers can use this data to reach out to members who need COVID-19 vaccination and bill for vaccine administration during office visits.
Action Required
Immediately: Primary care providers should access monthly HEDIS Care Gap Reports via provider portal or Cozeva platform to identify unvaccinated members (those over 5 years old not appearing on COVID-19 Vaccine measure). Contact PPG if reports are not received. Continue entering all vaccinations into California Immunization Registry (CAIR) in timely manner. Bill Medi-Cal at PPS rate for COVID-19 vaccines administered during billable office visits, with each dose separately reimbursable.