The Community Supports Coding Changes You Probably Missed in DHCS's January 2026 Update
August 21, 2026
Quick summary: DHCS released version 1.31 of the ECM and Community Supports HCPCS Coding Guidance in January 2026. The headline changes: new codes for distinct Community Supports subservices, a substantially expanded food and nutrition code set, and clarified modifier descriptions for cases where the same HCPCS code is used across multiple Community Supports. DHCS also stated for the first time that these codes are interim, pending permanent codes.
Why this update is easy to miss
Coding guidance updates don't come with an APL or a webinar series. They appear as a new version of a PDF on the DHCS resources page, and unless somebody on your team is checking, your configuration quietly drifts out of date.
Version 1.31 is worth a real read, because the changes are not cosmetic. If you deliver medically tailored meals or medically supportive food, your entire code set was restructured.
Change one: the food and nutrition benefit got granular
Previously, Medically Tailored Meals / Medically Supportive Food was coded loosely. The January 2026 update carved it into distinct, separately-coded subservices — mostly by adding modifiers to S9977 and repurposing S9452.
| Subservice | Code | Modifier | |---|---|---| | Medically Tailored Meals (per meal) | S5170 | U6 | | Nutrition Education — individual session (per 15 min) | S9452 | U5 | | Nutrition Education — group session (per 15 min) | S9452 | U6 | | Nutritional Assessment (per 15 min) | S9470 | U6 | | Medically Tailored Groceries (per week) | S9977 | U6 | | Medically Supportive Groceries (per week) | S9977 | U7 | | Produce Prescription — box (per week) | S9977 | U4 | | Produce Prescription — retail (per week) | S9977 | U5 | | Food Pharmacy (per session) | S9977 | U8 | | Healthy Food Vouchers (per month) | S9977 | U9 |
If you were previously reporting everything under a single meals code, this is a configuration project, not a footnote. Six distinct modifiers now hang off S9977 alone.
Change two: clarified modifiers where codes overlap
Several HCPCS codes are used across more than one Community Support, and the modifier is the only thing distinguishing them. DHCS rewrote these descriptions for clarity in January 2026. The ones worth double-checking:
H0043 — used for both Housing Transition Navigation (U6) and Short-Term Post-Hospitalization Housing (U3). The modifier is the entire distinction.
H0044 — used across three different services:
- U2 = Housing Deposits
- U3 = Short-Term Post-Hospitalization Housing (per month option)
- U5 = Community or Home Transition Services: non-recurring set-up expenses (this pairing was updated in January 2026)
T2038 — used for both Assisted Living Facility Transitions (U4) and Community or Home Transition Services (U5).
S5165 — used for both Environmental Accessibility Adaptations (U6) and Asthma Remediation (U5).
If your billing configuration maps codes to services rather than code-and-modifier pairs to services, you have a latent misrouting problem.
Change three: the codes are officially temporary
DHCS added a notice that the HCPCS codes and modifiers in this document remain in use only until permanent codes are established. DHCS also clarified that because modifiers are used differently across DHCS programs, the guidance defines modifier use specifically for ECM and Community Supports.
That second point matters for any organization operating across programs. A U6 in the Community Supports context does not carry a portable meaning.
Worth re-confirming: the rule on extra codes
This isn't new in the January update, but it remains the most commonly violated provision in the entire document.
MCPs may not require or allow Community Supports providers to report codes or modifiers beyond those DHCS established — even where the plan and provider mutually agree to them. DHCS has stated it is working directly with plans that were still permitting or requiring additional codes.
Plans retain flexibility on payment models. An MCP can pay a Housing Transition Navigation provider on a PMPM basis if it wants. But it must still require the provider to report the DHCS codes and modifiers on a standard per-diem basis underneath that payment arrangement.
The Rule of Eights
For any Community Support billed in 15-minute increments, DHCS applies the Rule of Eights: at least eight minutes of service must occur to report the first 15-minute increment, and the same threshold applies to each subsequent increment.
This applies to the housing outreach codes as well. Successful or unsuccessful outreach efforts lasting seven minutes or less do not meet the threshold and are not reportable.
Practically, this means your documentation needs actual elapsed time on the encounter — not a checkbox saying the service happened. A system that captures start and stop times handles the Rule of Eights automatically. One that doesn't leaves your billing staff estimating, which is exactly what an audit looks for.
The housing outreach codes
DHCS added required outreach reporting for three housing Community Supports — Housing Transition Navigation, Housing Deposits, and Housing Tenancy and Sustaining Services:
| Modality | Code | Modifier | |---|---|---| | In-person outreach, per 15 min | T1016 | U8 | | Telephonic/electronic outreach, per 15 min | T1016 | U8, GQ |
Three things about these:
- They must be reported for both successful and unsuccessful outreach efforts.
- They apply only to outreach that initiates service delivery — not to ongoing efforts to keep an already-enrolled member engaged.
- Mass communications don't count. Individualized texts or secure emails to a specific member do.
Note that DHCS was clear these coding requirements do not by themselves change reimbursement policy, and plans are not required to pay for outreach. DHCS encourages plans and providers to develop payment models that do. Report them regardless — DHCS has said the data will inform future policy development, which is to say future reimbursement decisions.
A naming note
If you are working from older documentation, some service names have shifted in current guidance. Respite Services now appears as Caregiver Respite. Nursing Facility Transition/Diversion to Assisted Living Facilities appears as Assisted Living Facility Transitions. Community Transition Services / Nursing Facility Transition to a Home appears as Community or Home Transition Services.
Same services, current labels. Worth updating in your internal materials so staff aren't searching for a service name your plan no longer uses.
Your reconfiguration checklist
- Rebuild the food and nutrition code set if you deliver MTM/MSF — it is now ten distinct subservices.
- Verify every code-and-modifier pair maps to exactly one service in your system, especially H0043, H0044, T2038, and S5165.
- Confirm elapsed time is captured on 15-minute-increment services so the Rule of Eights applies cleanly.
- Make sure housing outreach attempts are recorded per attempt, with modality and outcome.
- Store codes as configuration, not logic — DHCS has told you these are interim.
- Ask each plan whether they are requiring any code or modifier not in the DHCS guidance. If yes, point them at the guidance.
Where CareAutomate fits
CareAutomate is an operations platform for Medicaid and HCBS providers. The reason coding updates like this one are painful is usually structural: services, codes, modifiers, and authorizations are configured in one place, documentation happens somewhere else, and the two only meet at month end.
CareAutomate configures services, codes, and modifiers per client and per contract, so a DHCS guidance update is a configuration change your team makes directly rather than a support ticket you wait on. Service documentation is captured at the point of delivery with elapsed time, modality, and timestamped electronic signatures, and unit tracking runs per member against the authorization — which is what makes the Rule of Eights and the audit trail work without manual arithmetic. Documented services convert into billing-ready output, including a compliant 837P generated from the service data.
If reconfiguring for the January 2026 changes is still on your list, book a walkthrough and we'll show you how the same change looks in a system built for it.
This article summarizes DHCS's ECM and Community Supports HCPCS Coding Guidance, version 1.31 (January 2026). Plans may differ on which coding option they require where multiple options exist — confirm your configuration against each MCP contract.