CHA News

Medi-Cal Coverage of Community Health Worker Services Effective July 1

This post has been archived and contains information that may be out of date.

On June 29, the Department of Health Care Services (DHCS) announced that, effective July 1, Medi-Cal will cover community health worker (CHW) services, including violence prevention and asthma prevention. 

Medi-Cal will cover CHW services as preventive services and on the written recommendation of a physician or other licensed practitioner within their scope of practice. CHWs may include individuals known by a variety of job titles such as promoters, community health representatives, navigators, and other non-licensed public health workers, including violence prevention professionals. 

CHW services may address issues that include — but are not limited to — the control and prevention of chronic conditions or infectious diseases; mental health conditions and substance use disorders; preventive services; perinatal health conditions; sexual and reproductive health; environmental and climate-sensitive health issues; child health and development; oral health; aging; injury; domestic violence; and violence prevention. Covered CHW services include health education, health navigation, screening and assessment, and individual support or advocacy.   

The DHCS announcement contains details on: 

  • CHW service definitions 
  • Non-covered CHW benefits and services 
  • CHW staffing minimum qualifications 
  • Beneficiary eligibility criteria to receive CHW services 
  • CHW services procedure codes and fee-for-service reimbursement rates 
  • CHW services documentation and plan of care requirements 
  • CHW services supervisory requirements for CHW services 
  • Specific requirements for asthma prevention and violence prevention CHW services