Initial Health Appointment Coding Guidance

Effective since January 1st, 2023, the Initial Health Assessment was retired by the Department of Health Care Services (DHCS) and replaced with the Initial Health Appointment (IHA), as addressed in DHCS All Plan Letter APL 22‑030 Initial Health Appointment. All Anthem members enrolled in Medi‑Cal Managed Care (Medi‑Cal) are required to receive an IHA within 120 days of enrollment. The IHA is a complete medical history, head‑to-toe physical examination, and assessment of health behaviors. The below wording and list of IHA compliant codes will be posted to our provider website at https://providers.anthem.com/california‑provider/home.

Code Your Services Correctly: Use the following Diagnosis and/or Procedure Codes to document IHA visits. The codes are informational only, not clinical guidelines or standards of medical care; this information does not guarantee reimbursement, benefit coverage, or payment. All member care and related decisions of treatment are the sole responsibility of the provider. This information does not dictate nor control your clinical decisions regarding the appropriate care of members. Your state/provider contract(s), Medicaid, member benefits, and several other guidelines determine reimbursement for the applicable codes.