The Initial Health Assessment (IHA) exam, as well as a Staying Healthy Assessment (SHA) form is required by the California Department of Health Care Services (DHCS) to be performed within the first 120 days of enrollment with Medi-Cal. DHCS guidelines indicate the provider must attempt to contact and schedule a member at least three times in order for the IHA to be considered compliant. During the public health emergency, DHCS is temporarily suspending the requirement to complete an Initial Health Assessment (IHA) within the 120-day timeframe, however DHCS will require the completion of the IHA for these members once the public health emergency is over. If your clinic has capacity to see new members and would like to incorporate telephonic visits, please see the below documentation requirements for billing telephonic IHA visits.
|Documentation Requirements for Billing Telephonic IHA Visits|
|Exam||8+ Organ Systems examined||8+ Organ Systems examined|
|Medical Decision Making||
|Time Spent||45 Minutes||60 Minutes|
Best Practice tips:
- SHA’s are not separately payable
- If in-office visits are not practical, utilize video visits for the physical exam and utilize best clinical judgement
- Document thoroughly
Please contact your provider Relations Representative with any questions (800) 700-3874 ext. 5504.