MedicaidCoverageHigh impact
26-586 Updated Youth Trauma Screening Requirements
Health Net·CA · Psychiatry, Pediatrics, Family Medicine·Reimbursement
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Effective April 1, 2026, only specific DHCS-approved trauma screening tools can be used for Medi-Cal members under 21 when assessing SMHS access, and only ACEs questionnaire or PEARLS qualify for Medi-Cal reimbursement under ACEs screening services. All other screening tools will not be reimbursed even if clinically appropriate.
Action Required
Immediately: Review all current youth trauma screening tools used with Medi-Cal members under 21. Billing team must ensure only DHCS-approved tools (ACEs questionnaire, PEARLS, CANS-Trauma Module, IP-CANS, CATS, CPSS-5-Screen, CTS, LEC-5, UCLA PTSD RI-5 BF) are used for SMHS access screening. For ACEs screening reimbursement, use ONLY ACEs questionnaire or PEARLS - all other tools will not be reimbursed. Update billing system to flag non-compliant screening tools. Providers must clearly document which screening tool was used and the purpose (SMHS access vs ACEs screening) in clinical notes. Update workflows and staff training materials immediately to prevent claim denials.