MedicaidDocumentationMedium impact
20-298 Complete the IHA within 120 Days to Help Manage Your Patient’s Health Care Needs
Health Net·CA · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health (Medi-Cal) requires Initial Health Assessments (IHA) to be completed within 120 days for all newly enrolled members in Fresno, Kings, and Madera counties. Specific billing codes are provided for IHA services and Staying Healthy Assessment forms, with detailed documentation requirements and exceptions processes.
Action Required
Immediately: Billing team must ensure IHA services for new CalViva Health Medi-Cal members are billed using appropriate codes (99202-99205, 99211-99215, 99381-99387, 99391-99397, 99461, G0438, G0439) and bill Staying Healthy Assessment using code 96156. Providers must complete IHA within 120 days of member enrollment and document all exceptions in medical records. Access monthly 120-Day Initial Health Assessment Reports online to identify members needing IHA.