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Initial Health Appointment (IHA) for Newly Enrolled Medi-Cal Members
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Medi-Cal members enrolled through the L.A. Care Direct Network must complete an Initial Health Appointment (IHA) in a primary care setting within 120 days of enrollment. The IHA can be completed over one or multiple visits and must be provided in a manner culturally and linguistically appropriate for the member. The letter states that the updated APL 22-030 removed the IHEBA/Staying Healthy Assessment requirement, but appropriate risk assessments and screenings should still be completed and documented. This is from a May 21, 2024 letter, so check current applicability with L.A. Care before applying it.
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What to do
Action · 8 steps
01REQUIREMENTS: Primary care providers must complete the IHA within 120 days of enrollment for newly enrolled members.
02Use the monthly IHA-Reports lists in the Provider Portal to outreach to members and schedule their IHA.
03Providers must document all IHA components in the member's medical record, including complete physical and mental health history, identification of risks, assessment for preventive screens or services, health education, and diagnoses and plan of treatment for any diseases.
04Document all member outreach, refusals and missed appointments in the member's chart.
05Billing team: submit the appropriate encounter and ICD-10 and CPT codes for any screening or treatment provided to capture the IHA, and share the enclosed IHA code list with office staff involved with claim or encounter submission.
06Submit telehealth IHA codes per originating and distant site factors.
07FQHCs use Place of Service 02-Telehealth when submitting professional telehealth service claims.
08Providers must provide evidence when requested for monitoring or auditing, such as proof of IHA components in a file review or proof of exclusions met through documented outreach.
Codes mentioned
Z00.00Z00.01Z00.1Z00.11Z00.12Z00.121Z00.129Z00.8Z71.89Z34.90Z34.93594005942559426595105961059618961529615652TS961589615996164961659920399204992059921399214992159924499245993049930599306994609946199463G0466G0470
Original notice
Initial Health Appointment (IHA) for Newly Enrolled Medi-Cal Members
lacare.org · Always check the source before changing claims.
Related policy hubs
L.A. Care Health Plan policiesCA policy changesFamily MedicineGeneral PracticeInternal MedicinePediatricsOB-GYNCode Z00.00Code Z00.01Code Z00.1Code Z00.11Code Z00.12Code Z00.121Code Z00.129Code Z00.8Code Z71.89Code Z34.90Code Z34.93Code 59400Code 59425Code 59426Code 59510Code 59610Code 59618Code 96152Code 96156Code 52Code TSCode 96158Code 96159Code 96164Code 96165Code 99203Code 99204Code 99205Code 99213Code 99214Code 99215Code 99244Code 99245Code 99304Code 99305Code 99306Code 99460Code 99461Code 99463Code G0466Code G0470