Kern Cut H0046 From ABA Contracts in February. CHG Withdrew Its Cutoff, CalABA Says.

SAN DIEGO – Community Health Group, a nonprofit health plan serving San Diego County that offers Medi-Cal coverage, has retracted a notice telling providers it would stop paying for HCPCS code H0046, a billing code used in applied behavior analysis treatment, the California Association for Behavior Analysis said October 14. The plan says on its website that it serves more than 324,000 members.

CalABA said San Diego-area providers flagged the notice, and its public policy team then contacted both the plan and the Department of Health Care Services, the state agency that runs Medi-Cal, to raise concerns and ask for clarification. The plan “has since retracted its original communication and confirmed continued reimbursement of H0046,” the association wrote. CalABA credited providers for reporting the problem quickly, which it said let the association respond fast.

The association called H0046 “a critical component of ABA treatment” but did not say which services providers bill under it, why the plan moved to drop it, or when the cutoff would have taken effect.

Another Medi-Cal managed care plan took a different approach to H0046 earlier in 2026. Kern Health Systems removed the code from its ABA contracts effective February 1, 2026, and told providers with active authorizations to bill remaining approved H0046 units under code H0032. Kern said claims submitted on or after February 1, 2026, using H0046 would be denied, and that the change aligned its contracts with the state’s Medi-Cal provider manual for behavioral health treatment and its approved service codes.

That manual’s procedure-code list is framed for enrolled fee-for-service BHT providers. It includes CPT codes 97151 through 97158 and HCPCS codes including H0032, but not H0046. That omission alone does not bar managed care plans from paying for the code.

H0046 is a national billing code described as “Mental health services, not otherwise specified.” Blue Shield of California Promise, another Medi-Cal plan, lists it in its BHT telehealth policy as “Supervision of BCaBA and/or ABA Paraprofessional.” Health Net’s California policy on ABA documentation requirements, revised in July 2026, lists H0046 but says a code’s inclusion “does not guarantee coverage.”

None of these documents sets one H0046 payment rule for Medi-Cal plans. DHCS makes plans the primary provider of medically necessary BHT for eligible members under 21, but whether a given H0046 claim gets paid turns on the plan’s coverage, authorization, billing, and contract terms.

CalABA has asked providers facing other reimbursement issues to contact the association by email.

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