Are you a Community Based Group looking to bill MediCal?
Community-based organizations integrated into California Medicaid can obtain certification more readily than assumed.
Aaron Holman
Co-Founder, Partner · June 15, 2025
Community-based organizations have long delivered essential care and are now being integrated into California's Medicaid program (MediCal). The certification process is more straightforward than many realize.
Transitioning to a MediCal-billable service model requires less effort than anticipated, with substantial resources available to support organizations through the process.
CalAIM Overview
CalAIM is a statewide initiative aimed at transforming the Medi-Cal system by providing more comprehensive care, with a focus on vulnerable populations and social determinants of health.
California's CalAIM waiver enables CBOs to bill for Enhanced Care Management (ECM) services and Community Supports (CS), including:
Housing assistance
Medically tailored meals
Respite services
Sobering centers
Three Critical Questions
Organizations should address:
What services align with ECM or CS offerings?
What are delivery costs?
How will documentation and billing occur?
Key Points
Most CBOs already deliver appropriate services; changes focus on documentation and claims processes
We provide an assessment tool to evaluate ECM/CS feasibility
Billing diversifies funding sources while supporting care oversight
Extensive resources exist to assist implementation
For more information, contact us at hello@theHealthColab.com
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