MedicaidAdministrativeMedium impact
20-287 Stay Current with MCAS Updates to Be Sure You Meet Performance Levels
Health Net·CA · Family Medicine, Internal Medicine, Pediatrics +2 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net updated the Managed Care Accountability Set (MCAS) quality measures for 2020, adding new behavioral health monitoring requirements and modifying diabetes care measures for Medi-Cal patients in specific California counties. Providers must meet national Medicaid 50th percentile performance levels and ensure timely claims submissions with proper coding.
Action Required
Immediately: Billing team must update encounter forms and EMR templates to include new ICD-10 codes Z71.3 for nutrition counseling, Z02.5 and Z71.82 for physical activity counseling for pediatric patients. Review HEDIS 2020 Volume 2 Technical Specifications for updated coding guidelines. Ensure timely submission of claims and encounters to meet MCAS performance requirements for Medi-Cal patients in Fresno, Kings, and Madera counties.