26-481m Complete Initial Health Appointments for New Members

Date: 04/14/26

Timely initial health appointments support preventive care and better health outcomes

Initial health appointments (IHAs) are a required first step in caring for new primary care members. IHAs help establish a baseline for ongoing care, identify health risks early, and support timely preventive services and treatment planning.

IHA requirements

Physicians and practitioners must complete IHAs for all new members in a primary care medical setting. IHAs must be performed according to the Population Health Management Policy Guide and managed care plan contract requirements and must be repeated as required.

IHAs must include:

• Review of physical and mental health history.
• Identification of risks.
• Assessment of preventive care needs.
• Health education and counseling.
• Diagnosis and treatment planning, as appropriate.

Clinical guidance and resources

For detailed guidance on IHA requirements, exceptions, billing codes and best practices, refer to the IHA tip sheet (PDF).

Additional requirements are outlined in the Department of Health Care Services All Plan Letter 26-001 (PDF).

Need assistance?

For questions about IHAs, contact CalViva Health at 888-893-1569.
 

This information applies to Physicians, Practitioners, Participating Physician Groups (PPGs), Hospitals, and Ancillary Providers.

This information applies to Medi-Cal in Fresno, Kings and Madera counties.