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
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