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MedicaidDocumentationMedium impact

20-297 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
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net requires Initial Health Assessments (IHA) to be completed within 120 days for all newly enrolled Medi-Cal members in specified California counties. Providers must use specific billing codes for the patient visit (99202-99215, 99381-99387, 99391-99397, 99461, G0438, G0439) and SHA assessment (96156), with documentation requirements for any exceptions.

Action Required

Action needed
Immediately: Billing team must ensure proper coding for Medi-Cal IHA visits using specified CPT codes (99202-99215 for visits, 96156 for SHA assessment). Front desk staff should schedule IHA appointments within 120 days of member enrollment and document all outreach attempts and exceptions in medical records. Providers must complete age-appropriate Staying Healthy Assessment forms and maintain documentation for audit compliance.

Affected Billing Codes

99202
99203
99204
99205
99211
99212
99213
99214
99215
99381
99382
99383
99384
99385
99386
99387
99391
99392
99393
99394
99395
99396
99397
99461
G0438
G0439
96156