CurrentmhnPolicy N/A

Housing Deposit services — Coverage Criteria and Authorization

Defines eligibility, allowable uses, authorization timing, limits, and provider requirements for one-time housing deposit supports to help eligible members establish a basic household. Applies to Medi-Cal members served under the Local Health Authority arrangements (e.g., CHPIV) in the specified service area.

Policy Summary

Payermhn

PolicyHousing Deposit services — Coverage Criteria and Authorization

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionRequest Housing Deposit items within 30 calendar days of lease move-in (utility statements allowed up to 60 days) and submit required documentation including the Housing Deposit Authorization Form and Housing Support Plan.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

$6,000Total lifetime maximum per member

30 daysAuth request window post move-in

60 daysUtility statements allowed

onceService frequency

H0044 U2Billing code

Coverage Criteria

General coverage criteria

Covered when ALL of the following are met:

Eligibility general: Member has an individualized Housing Support Plan documenting need for identified Housing Deposit services/goods and the request is supported by required documentation (Housing Deposit Authorization Form and supporting documents).

See documentation list for examples; lease agreement often required.

Social eligibility: Member is experiencing or at risk of homelessness.

(Social Risk Factor Requirement)

Clinical eligibility: Member meets one or more qualifying clinical risk factors: meets access criteria for Specialty Mental Health Services (SMHS); meets access criteria for Drug Medi-Cal (DMC) or DMC-ODS; has one or more serious chronic physical health conditions; has one or more physical, intellectual, or developmental disabilities; or is pregnant through 12 months postpartum.

Policy Summary

Payermhn

PolicyHousing Deposit services — Coverage Criteria and Authorization

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Definitions and Eligibility

One-time supports and goods — examples

Examples of covered one-time supports and goodsSecurity deposits required to obtain a lease; setup fees/deposits for utilities or service access and utility arrears; first-month coverage of utilities; application fees to cover the cost of the lease application; goods such as medically necessary adaptive aids (e.g., hospital beds, Hoyer lifts, air filters) that preserve health and safety; services necessary for health and safety (e.g., pest eradication, one-time cleaning, minor repairs).

Tied to Housing Support PlanAll items must be based on an individualized assessment of needs and documented in the member's Housing Support Plan; member may require only a subset of these services/goods.

Documentation examplesRequired documentation includes Housing Deposit Authorization Form and Housing plan plus supporting documents such as lease agreement, Medi‑Cal DME denial letter, invoice for cleaning/pest service, Security Deposit Exemption Form, or other verification documents.

LimitationsFirst month and last month's rent are not covered under this benefit.

Total lifetime maximumTotal lifetime maximum per member: $6,000.

Member eligibility — social and clinical risk factors

Social eligibility requirementMember is experiencing or at risk of homelessness (Social Risk Factor Requirement).

Clinical eligibility — SMHS or DMCMember meets access criteria for Specialty Mental Health Services (SMHS) or meets access criteria for Drug Medi‑Cal (DMC) or DMC‑ODS.

Clinical eligibility — chronic conditions or disabilitiesMember has one or more serious chronic physical health conditions, or one or more physical, intellectual, or developmental disabilities.

Clinical eligibility — pregnancyMember is pregnant through 12 months postpartum.

Combined requirement (actionable)Member must be experiencing or at risk of homelessness AND meet one or more qualifying clinical risk factors to qualify for Housing Deposit services.

Provider Actions and Authorization Rules

Prior Authorization

Timely submission and allowed pre-move requests

Housing Deposit items must be requested within 30 calendar days of the lease move-in date. Utility statements are an exception and may be submitted up to 60 calendar days from the move-in date. Providers may request certain items (for example, application fees or goods) prior to move-in, but any additional items needed after move-in must be requested within the 30-day timeframe tied to the documented lease move-in date.

Request within 30 calendar days of lease move-in date (except utility statements: up to 60 days).
Pre-move requests allowed for application fees or goods; post-move additional items must meet the 30-day rule.

Denial Risk

Frequency and repeat authorization

Housing Deposit services are available once within the demonstration period. A second approval may be granted only with documentation showing changed conditions and justification that a second Housing Deposit would be more successful.

Standard frequency: one time within the demonstration period.
Possible one-time additional approval only with documentation of changed circumstances and justification.

Step Therapy

Step therapy

No step therapy requirements apply to Housing Deposit services.

Documentation Required

Required documentation

Required documentation must be submitted with the authorization request and include: the Housing Deposit Authorization Form and the member's Housing Support Plan documenting the individualized assessment and listing the specific services/goods requested. Supporting documentation may include the lease agreement (showing move-in date), utility bills/statements (within allowable timeframe), invoices (e.g., cleaning or pest service), Medi-Cal DME denial letter (if applicable), Security Deposit Exemption Form (if used), and any other documents needed to verify the need for services and the reasonableness/necessity in the Housing Support Plan.

Housing Deposit Authorization Form
Housing Support Plan documenting individualized needs and justification
Lease agreement (showing move-in date)
Utility statements (if used — must meet 60-day allowance)
Invoices (e.g., cleaning/pest services), Medi-Cal DME denial letter, Security Deposit Exemption Form, other supporting documents as needed

Note

Provider qualifications

Providers must document experience and expertise in housing-related services and supports, deliver services in a culturally and linguistically appropriate manner, and follow best practices. Examples of eligible provider types include interim housing facilities with on-site support, shelter beds with on-site support, converted homes with on-site support, county-operated or contracted recuperative care facilities, supportive housing providers, county agencies, public hospital systems, social service agencies, and providers serving individuals experiencing homelessness.

Document housing-related experience and expertise
Provide services in a culturally and linguistically appropriate manner and follow best practices
Eligible provider examples: interim housing, shelters with on-site support, recuperative care facilities, supportive housing providers, county agencies, public hospitals, social service agencies

OpenPayer

Housing Deposit services — Coverage Criteria and Authorization

Coverage Criteria

Definitions and Eligibility

Provider Contract Codes

Provider Actions and Authorization Rules

Background