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MedicaidDocumentationMedium impact

21-794 Submit Social Determinants of Health Data on Your Claims or Encounters

Health Net·CA·Coding
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net now requires providers in 9 California counties to submit Social Determinants of Health (SDOH) data using 18 specific ICD-10-CM Z-codes on Medi-Cal claims and encounters. This supports the CalAIM Population Health Management initiative to improve health equity and identify health disparities.

Action Required

Action needed
Immediately: Providers in Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties must begin documenting and submitting the 18 priority SDOH Z-codes on Medi-Cal claims and encounters when applicable to patients. Update EMR templates to include SDOH screening questions and ensure billing team is trained to submit these ICD-10-CM codes with appropriate claims.

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