Who is affected by this change?

This affects Health Net in CA on Medicaid plans.

MedicaidDocumentationMedium impact

21-796 Submit Social Determinants of Health Data on Your Claims or Encounters

Q: Which billing codes are affected?

The following codes are affected: 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.

Health Net·CA·Coding

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

Healthcare providers in Fresno, Kings, and Madera counties must now submit Social Determinants of Health (SDOH) data using 18 specific ICD-10-CM Z-codes on Medi-Cal claims and encounters. This requirement supports the CalAIM Population Health Management initiative to improve health equity and identify health disparities.

Action Required

Action needed

Immediately: Providers in Fresno, Kings, and Madera counties must begin documenting and submitting the 18 DHCS priority SDOH Z-codes on Medi-Cal claims and encounters when applicable to patients. Update EMR templates to include SDOH assessment fields. Train clinical staff to identify and document social determinants of health issues using the specified ICD-10-CM codes. Contact CVH-CAP@healthnet.com or CalViva Health at 888-893-1569 with questions.

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

21-796 Submit Social Determinants of Health Data on Your Claims or Encounters

Summary

Action Required

Affected Billing Codes

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