Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.31
    OpenPayerPolicy UpdatesAdministrative/Operational PolicyPHC California Transitional Rent Coverage | OpenPa…
    Ask Trek AI about this page
    CurrentPHC CaliforniaPolicy PR 28.0

    PHC-CA Responsibilities to Transitional Rent Community Support Providers

    Customize your policy alerts

    Sign up for phccalifornia Policy PR 28.0 alerts

    Get alerted when Policy PR 28.0 changes without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    This policy governs PHC California’s contracting, oversight, payment, and coordination responsibilities for Transitional Rent Community Support Providers and related entities serving eligible enrollees experiencing or at risk of homelessness.

    Policy Summary
    PayerPHC California
    PolicyPHC-CA Responsibilities to Transitional Rent Community Support Providers
    Policy CodePolicy N/A
    Change TypeNo material change
    Effective DateJan 1, 2026
    Last ReviewSep 7, 2025
    Next Review DateN/A
    Key ActionContracted Transitional Rent Providers must ensure housing units are habitable, issue timely payments, and coordinate with the Health Plan ECM Team and other supportive-service providers.
    SourceLink
    POLICY UPDATE CHANGES

    No material clinical or coverage changes in this revision.

    6 monthsMaximum assistance period
    8Eligible provider categories
    $0Enrollee housing cost share
    DHCS ceilingsReimbursement limit

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    AnnualReview frequency

    Transitional Rent Coverage and Payment Criteria

    Transitional Rent Community Support administration criteria

    Transitional Rent Community Support is available through contracted providers for eligible Medi-Cal enrollees experiencing or at risk of homelessness. All of the following apply:

    ALL of the following

    • ALL of the following

      • The enrollee is experiencing or at risk of homelessness.
      • The enrollee has certain clinical risk factors and has either recently undergone a critical life transition, such as exiting an institutional or carceral setting or foster care, or meets other specified eligibility criteria.
      • The benefit provides up to six months of rental assistance in interim or permanent settings.

    • ALL of the following

      • The Health Plan contracts with a Transitional Rent Provider to administer the benefit.
      • The Transitional Rent Provider identifies appropriate settings and units, ensures that housing units are habitable, assists the enrollee with reviewing, understanding, and executing a legally compliant lease, structures rent-payment arrangements with the landlord or property owner, issues timely payments, and coordinates with the Health Plan ECM Team and other involved housing or supportive-service providers.
      • The Health Plan remits Transitional Rent payments to the provider rather than paying rent directly to the landlord.

    • ALL of the following

      • The enrollee must not be required to pay any share of rent or housing costs.

    Transitional Rent payment criteria

    Provider reimbursement is subject to all of the following operational payment rules:

    ALL of the following

    • The Health Plan uses non-risk payments from the Department of Health Care Services (DHCS), separate from and in addition to usual capitation payments, to pay Transitional Rent Providers.
    • Reimbursement covers the provider's actual cost of rent or temporary housing paid to the landlord or property owner.
    • Reimbursement must not exceed the amounts set by DHCS in the schedule of reimbursable ceilings.DHCS-specified reimbursable ceilings
    • Whenever feasible, provisional supplemental DHCS payments or other funds may be used prospectively, with reconciliation to follow, to support timely provider cash flow and house enrollees as quickly as possible.

    Payment Parameters

    Maximum Transitional Rent duration
    Maximum durationUp to six months
    Covered settingInterim and permanent settings
    Benefit typeRental assistance under a Medi-Cal benefit
    Reimbursement limit
    Reimbursement basisActual cost of rent or temporary housing paid by the provider to the landlord or property owner
    Payment sourceNon-risk payments from the Department of Health Care Services (DHCS), separate from and in addition to usual capitation payments
    Reimbursement ceiling

    Health Plan and Provider Responsibilities

    Documentation Required

    Complete required housing and coordination duties

    Contracted Transitional Rent Providers must identify appropriate settings and units, ensure that housing units are habitable, help enrollees review, understand, and execute legally compliant leases, structure rent payment agreements with landlords or property owners, issue timely payments, and coordinate with the Health Plan ECM Team and other involved housing or supportive-service providers.

    • Identify appropriate settings and units.
    • Ensure housing units are habitable.
    • Help enrollees review, understand, and execute legally compliant leases.
    • Structure rent payment agreements and issue timely payments.
    • Coordinate with the ECM Team and other involved supportive-service providers.
    Documentation Required

    Complete provider enrollment or vetting

    The Health Plan must evaluate each Transitional Rent Provider’s experience and expertise. Providers must enroll in Medi-Cal when a state-level enrollment pathway exists; when no pathway exists, they must undergo vetting addressing referral capacity, homelessness-service experience, claims or invoice submission, licensing, oversight compliance, fraud, waste, abuse, criminal activity, and liability history.

    Key Terms

    Transitional Rent
    BenefitA Medi-Cal benefit providing rental assistance
    Duration and settingsUp to six months in interim and permanent settings
    Purpose and eligibility contextFor enrollees experiencing or at risk of homelessness who have certain clinical risk factors and have recently undergone a critical life transition or meet other specified eligibility criteria
    Flexible Housing Subsidy Pools (Flex Pools)
    Managing entityA single entity manages landlord engagement and administers rental assistance
    Housing supportsThe entity coordinates related housing supports
    Policy Summary
    PayerPHC California
    PolicyPHC-CA Responsibilities to Transitional Rent Community Support Providers
    Policy CodePolicy N/A
    Change TypeNo material change
    Effective DateJan 1, 2026
    Last ReviewSep 7, 2025
    Next Review DateN/A
    Key ActionContracted Transitional Rent Providers must ensure housing units are habitable, issue timely payments, and coordinate with the Health Plan ECM Team and other supportive-service providers.
    SourceLink
    On This Page
    Transitional Rent Coverage and Payment CriteriaPayment ParametersHealth Plan and Provider ResponsibilitiesKey Terms
    The Health Plan should strive to expedite payment when an enrollee's housing needs are urgent and the Transitional Rent Provider cannot front the first rent payment, including when the enrollee is experiencing unsheltered homelessness or is at imminent risk of unsheltered homelessness.
    Must not exceed amounts set by DHCS in a schedule of reimbursable ceilings
    • Evaluate the provider’s experience and expertise for the functions it will perform.
    • Complete Medi-Cal enrollment when a state-level pathway is available.
    • If no pathway exists, complete the applicable vetting process.
    Documentation Required

    Pursue required county and Flex Pool contracts

    The Health Plan must offer a Transitional Rent Provider contract to the county behavioral health agency or its designated county department or agency. If contracting is not possible, it must make a good-faith effort to contract with the agency’s housing-provider network and seek a contract with the county Flex Pool department or contracted Flex Pool operator.

    • Offer a contract to the county behavioral health agency or designated department or agency.
    • Pursue the county behavioral health agency’s housing-provider network if needed.
    • Seek a contract with the county Flex Pool department or contracted Flex Pool operator.
    Billing Rule

    Apply the correct reimbursement basis

    The Health Plan must use non-risk payments from the Department of Health Care Services (DHCS) to pay Transitional Rent Providers; these payments are separate from and in addition to usual capitation payments. Reimbursement is limited to the provider’s actual rent or temporary housing cost paid to the landlord or property owner and may not exceed DHCS-specified reimbursable ceilings.

    • Use non-risk DHCS payments for Transitional Rent Provider payments.
    • Keep these payments separate from usual capitation payments.
    • Reimburse only actual rent or temporary housing costs paid to the landlord or property owner.
    • Do not exceed DHCS reimbursement ceilings.
    Billing Rule

    Use prospective funding and expedite urgent payments

    Whenever feasible, the Health Plan should use provisional supplemental DHCS payments or other funds to pay Transitional Rent Providers prospectively, with reconciliation to follow. Payment should be expedited when housing needs are urgent and the provider cannot front the first rent payment, including for enrollees experiencing or imminently at risk of unsheltered homelessness.

    • Use prospective provisional payments whenever feasible.
    • Reconcile payments after prospective funding.
    • Expedite payment for urgent housing needs when the provider cannot front the first rent payment.
    Denial Risk

    Do not impose enrollee cost sharing

    Transitional Rent Providers must not require enrollees receiving Transitional Rent to cover any share of rent or housing costs.

    • Do not charge the enrollee any share of rent.
    • Do not require the enrollee to pay any share of housing costs.
    Documentation Required

    Report and escalate provider deficiencies

    The ECM Program Manager or designee must report deficiencies in Transitional Rent Provider performance to the Health Plan Administrator and Compliance Officer for action.

    • Monitor Transitional Rent Provider performance.
    • Report identified deficiencies to the Health Plan Administrator and Compliance Officer.
    • Pursue corrective action through the designated oversight process.
    Funding arrangement
    Services are provided on behalf of multiple contributing funders
    Continuum of Care (CoC)
    Geographic scopeA community-wide or regional coalition operating in its geographic area
    Participating stakeholdersNonprofits, government agencies, housing providers, behavioral health providers, and people with lived experience of homelessness
    FunctionCoordinates strategies to end homelessness
    Mental Health Services Act (MHSA)
    State lawA California state law passed by voters in 2004
    EnactmentProposition 63
    Funding purposeCreated a major, ongoing source of funding for mental health services
    Behavioral Health Services Act (BHSA)
    Enactment and timingA California state law passed as part of Proposition 1 in March 2024
    Relationship to MHSAReplaces the Mental Health Services Act (MHSA)
    Broader scopeExplicitly includes substance use disorder (SUD) treatment in addition to mental health services