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Health NetMedicaid · Reimbursement · Reimbursement · CA · Family Medicine, Internal Medicine, General Practice +2 moreMedium impact

20-026 Prop 56 Rates Extended for SFY 2019-2021

Act
immediately
Effective date
Jul 1, 2019
Identified
Jun 20, 2026

Summary

Proposition 56 supplemental payment rates for Medi-Cal physician services have been extended through December 31, 2021, maintaining the same rates as SFY 2018-2019. These supplemental payments apply to specific CPT codes for office visits, preventive care, and psychiatric services in seven California counties.

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What to do

immediately · 4 steps
01Billing team must ensure current W-9 forms are on file for all providers to receive Prop 56 supplemental payments.
02Submit W-9 forms to HNCA_W9_Submissions@CENTENE.COM with 'Prop 56 W9' in subject line or fax to 1-833-794-0423.
03Verify claims are submitted with qualifying CPT codes for Medi-Cal patients in Kern, Los Angeles, Sacramento, San Diego, San Joaquin, Stanislaus, and Tulare counties.
04Supplemental payments will be made within 90 days of clean claims.

Codes mentioned

9079190792908639920199202992039920499205992119921299213992149921599381993829938399384993859939199392993939939499395

Original notice

20-026 Prop 56 Rates Extended for SFY 2019-2021
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
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Related changes

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20-028 Prop 56 Rates Extended for SFY 2019-2021MediumEffective Jul 1, 2019 · Reimbursement20-297 Complete the IHA within 120 Days to Help Manage Your Patient’s Health Care NeedsMediumNo effective date · Prior Authorization20-298 Complete the IHA within 120 Days to Help Manage Your Patient’s Health Care NeedsMediumNo effective date · Prior Authorization20-178 Patient Assessment Form No Longer Needed to Get IncentiveMediumNo effective date · ReimbursementBrowse every Health Net change in the policy list

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