MedicaidAdministrativeMedium impact
20-926 Notice of Correction for 20-799, Change to Financial Responsibility for Diagnostic Testing
Health Net·CA · Sleep Medicine, Pulmonology·Provider News
We identified it
Jun 20, 2026
Summary
This notice corrects previous guidance about in-home sleep studies for Medi-Cal patients. Participating physician groups that have diagnostic testing financial risk for outpatient facilities are also financially responsible for in-home sleep studies, including both technical and professional components. No changes to the Division of Financial Responsibility are required on January 1, 2021.
Action Required
Immediately: Billing teams for PPGs with outpatient diagnostic testing financial risk must ensure in-home sleep studies are processed under their financial responsibility rather than being billed to Health Net. Update billing procedures to treat in-home sleep studies the same as outpatient facility diagnostic tests for both technical and professional components.