MedicaidDocumentationMedium impact
Initial Health Appointment (IHA) for Newly Enrolled Medi-Cal Members
L.A. Care Health Plan·CA · Family Medicine, Internal Medicine, General Practice +2 more·Provider Communication
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
L.A. Care updated requirements for Initial Health Appointments (IHA) for newly enrolled Medi-Cal members, removing the IHEBA/SHA requirement but maintaining comprehensive physical/mental health assessments within 120 days of enrollment. Providers must use specific billing codes and document all IHA components in medical records.
Action Required
Immediately: Billing team must update encounter forms and billing software to include IHA-specific CPT and ICD-10 codes for L.A. Care Medi-Cal members. Providers must document comprehensive physical/mental health history, risk identification, preventive screenings, health education, and treatment plans within 120 days of member enrollment. Use telehealth modifier codes when applicable and ensure all IHA components are documented in medical records for audit purposes.