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25-978m Earn $75 for Early Pregnancy Confirmation

Date: 09/26/25

Support timely prenatal care and get rewarded. Incentive offer ends December 31, 2025

Primary care physicians (PCPs) participating in the 2025 HEDIS® Improvement Program (HIP) can earn a $75 incentive for each eligible Medi-Cal member whose pregnancy is confirmed early. This supplemental payment recognizes providers who help ensure timely access to prenatal care.

Eligibility requirements

To qualify for the $75 Confirmation of Pregnancy incentive, PCPs must:

  • Be contracted with Health Net*, on behalf of Community Health Plan of Imperial Valley (CHPIV), or a contracted participating physicians group (PPG) under the Medi-Cal program.
  • Be in good standing with the Plan and their PPG with no licensing or credentialing restrictions.
  • Accurately complete and submit the Confirmation of Pregnancy form within the required time frame. The completed form must include all required signatures.

When to use Confirmation of Pregnancy form

To receive the incentive, submit the form when:

  • The member confirms pregnancy during the first trimester, or
  • Within 42 days of enrolling in Medi-Cal with the Plan.

The form must include:

  • Member information.
  • Pregnancy information.
  • Rendering practitioner’s information.

How to access and submit the form

The Confirmation of Pregnancy Form (PDF) is available in the Provider Library under Forms and References. Submission instructions are included on the form.

Payment schedule

Incentives are processed semiannually. PCPs will receive $75 per complete and accurate form faxed to the Plan prior to the close of December 31, 2025.

Key program details

  • This incentive is separate from base provider compensation under the Medi-Cal Provider Participation Agreement.
  • It does not affect contracting rates with PPGs.
  • Only forms submitted within the required time frame and completed correctly will be eligible for payment.

Additional Information

Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact Community Health Plan of Imperial Valley at 833-236-4141.

 

This information applies to Physicians.

This information applies to Medi-Cal in Imperial County.



Last Updated: 09/26/2025