26-1182m 2025 Provider Access Survey Results
Date: 10/28/26
Review 2025 access survey results and corrective action requirements
Results from the 2025 Provider Appointment Availability Survey (PAAS) and Provider After-Hours Access Survey are now available for review. These surveys, conducted between August and December 2025, evaluated compliance with Department of Managed Health Care (DMHC) and Department of Health Care Services (DHCS) access-to-care requirements.
Important: These surveys fulfilled regulatory requirements from both the DMHC and DHCS. Physicians, practitioners and other providers who do not meet access standards are subject to a corrective action plan (CAP).
Survey results
The 2025 PAAS results identified several timely access standards that did not achieve the 70% provider availability performance goal.
Areas that fell below the performance goal include:
- Urgent care appointment with a specialist that requires prior authorization within 96 hours.
- Non-urgent appointment with a specialist within 15 business days.
Corrective action plan for affected providers
Physicians, practitioners or provider groups that do not meet urgent or non-urgent appointment access standards will receive a CAP from Health Net.
If you receive a CAP, you must:
1 Submit a written improvement plan (IP) within 30 days describing how each issue was addressed.
2 Provide a signed statement confirming:
- Access standards were not met.
- Survey results were shared with applicable providers.
3 Provide additional documentation if requested by the Plan to validate corrective actions.
4 Attend the Plan’s online training webinar as part of the improvement process.
For questions about access standards or corrective action requirements, email CVH-CAP.
Additional resources are available at Health Net. Go to Provider Quality Improvement, then select Quality Improvement. Look for Improve Health Outcomes: A Guide for Providers – CalViva Health (PDF) under Provider Resources.
2026 surveys are underway
The 2026 Provider Appointment Availability Survey and After-Hours Access Survey are currently in progress.
Physicians, practitioners and other providers will receive an email or fax with instructions for completing the surveys online. Responses should be submitted within five business days.
A phone survey may be conducted when:
- A physician, practitioner or other provider does not respond within five business days.
- A physician, practitioner or other provider’s email address or fax number is not available.
Note: DMHC accepts telehealth as a valid next available appointment.
Best practices for meeting access standards
To support timely access to care:
- Review appointment scheduling and after-hours procedures regularly.
- Train office staff and answering service staff on access standards and approved scripts.
- Conduct self-audits and secret shopper calls to evaluate appointment availability and after-hours messaging.
For help, visit the Provider Library, which includes after-hours scripts in multiple languages.
You may not need to complete the PAAS in 2027
Primary care physicians (PCPs) who qualify as Advanced Access Providers will automatically meet urgent and non-urgent appointment standards and are exempt from completing the PAAS survey for the next three years.
If any PCPs in your practice offer same-day appointments, contact us at DMHC Access IP.
Measurement year (MY) 2025 vs. MY 2024 Medi-Cal provider appointment availability results – overall
Access measure | Appointment standard | Performance goal | MY 2025 rate (%) | MY 2024 rate (%) |
|---|---|---|---|---|
PCPs and specialists | ||||
Urgent care appointment with PCP | 48 hours | 70% | 76.0 | 77.0 |
Urgent care appointment with specialist | 96 hours | 58.0 | 53.0 | |
Non-urgent appointment with PCP | 10 business days | 84.0 | 86.0 | |
Non-urgent appointment with specialist | 15 business days | 63.0 | 67.0 | |
Ancillary providers | ||||
Non-urgent ancillary appointment for magnetic resonance imaging (MRI), mammogram, physical therapy | 15 business days | 70% | 81.0 | 91.0 |
Behavioral health providers | ||||
Urgent care appointment with psychiatrist | 96 hours | 70% | 70.0 | 57.0 |
Non-urgent appointment with psychiatrist | 15 business days | 70.0 | 88.0 | |
Urgent care appointment with non-physician mental health provider (NPMH) | 96 hours | 80.0 | 82.0 | |
Non-urgent appointment with NPMH provider | 10 business days | 87.0 | 93.0 | |
Non-urgent follow up appointment within 10 business days of request (NPMH) | 10 business days | 80% | 87.0 | 94.0 |
2025 After-Hours Access survey results
The performance goal of 90% for After-Hours Emergency Instructions was met. However, the Ability to Contact On-Call Physician After Hours measure did not meet the performance goal
MY 2025 vs. MY 2024 Medi-Cal provider after-hours availability results – overall | ||||
Access measure | Standards | Performance goal | MY 2025 rate (%) | MY 2024 rate (%) |
After-hours emergency instructions | Appropriate instructions for emergency issues | 90% | 93.7 | 93.1 |
Contact on-call physician after hours (for urgent issues) | Callback within 30 minutes | 86.9 | 90.2 | |
MY 2025 vs. MY 2024 Telephone Access survey
To monitor telephone access, the Medi-Cal Telephone Access Survey was administered in 2025. A random sample of PCPs was selected and contacted to assess performance for two metrics: (1) Appropriate answer time: percent provider offices were able to answer phone calls within 60 seconds, and (2) ability to call back members for non-urgent issues within one business day. The performance goal of 90% for Telephone Answer Time was met. For Provider Call-Back for non-urgent issues during normal business hours, resulted in a non-passing rate.
Access measure | Standards | Performance goal | MY 2025 rate (%) | MY 2024 |
|---|---|---|---|---|
Telephone answer time | Within 60 seconds | 90% | 100.0 | 100.0 |
Provider callback for non-urgent issues during normal business hours | Within one business day | 61.8 | 55.6 |
MY 2025 Member In-Office Wait Time
In 2025, the Plan monitored members’ in-office wait time during an appointment at PCPs’ and specialists’ offices through a provider survey. The standard for this access survey is for members’ wait time to not exceed 30 minutes upon arrival when waiting for a scheduled appointment. Results of the 2025 CalViva In-Office Wait Time survey for PCPs show an overall compliance rate of 86.5%, exceeding the Plan’s performance goal of 70%.
Access measure | Standards | Performance goal | MY 2025 | MY 2024 |
|---|---|---|---|---|
In-office wait time at PCP’s office | Wait time upon arrival after set appointment time not to exceed 30 minutes | 70% | 86.5 | 72.1 |
In-office wait time at specialist’s office | Wait time upon arrival after set appointment time not to exceed 30 minutes | 77.2 | 77.4 |
Need help? Contact us
If you have questions, email DMHC Access IP or contact CalViva Health at 888-893-1569. Behavioral health providers can call 844-966-0298.
This information applies to Physicians and Practitioners, Participating Physician Groups (PPGs), Ancillary Providers, and Behavioral Health Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.