Collecting Social Determinants of Health (SDOH) Data – DHCS APL 21-009
| Date: | August 26, 2026 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) |
| To: | Health Plan All Providers |
| Type: | Informational/Educational |
| Subject: | Collecting Social Determinants of Health (SDOH) Data – DHCS APL 21-009 |
| Business: | Medi-Cal Managed Care |
Purpose
DHCS All Plan Letter (APL) 21-009 (Revised) directs Medi-Cal managed care plans and their network providers to consistently screen for and code Social Determinants of Health (SDOH) using a standardized set of ICD-10-CM codes. Detailed information can be found here: https://www.dhcs.ca.gov/wp-content/uploads/2025/10/APL21-009.pdf
This alert summarizes what’s required and how to document it.
Background
Initially introduced in 2019, SDOH data collection supports CalAIM’s Population Health Management (PHM) initiative, which identifies and addresses member health, social, and risk needs through a whole-person-care approach. Reliable SDOH data drives care coordination, referrals to Enhanced Care Management (ECM) and Community Supports (ILOS), and statewide health equity reporting.
What’s Required
- Screen members for social needs (e.g., using PRAPARE, the AHC Health-Related Social Needs tool, or a similar validated screening tool) as part of routine care.
- Document any identified social need using the applicable DHCS Priority SDOH Code (ICD-10-CM) below, and include it on the encounter/claim.
- Any contracted provider — not only the member’s PCP — may document and code SDOH, including subcontractors, ECM, and ILOS providers.
DHCS Priority SDOH Codes (25 Codes)
In 2022, DHCS identified and designated 25 SDOH codes to collect reliable SDOH data for Medi-Cal members. These 25 codes are prioritized for actionable data capture; for the full Z55–Z65 code range (97 codes) refer to the DHCS APL 21-009.
| Code | Description | Code | Description |
| Z55.0 | Illiteracy/low-level literacy | Z59.89 | Other housing/economic problems |
| Z58.6 | Inadequate drinking-water supply | Z60.2 | Problems related to living alone |
| Z59.00 | Homelessness, unspecified | Z60.4 | Social exclusion and rejection |
| Z59.01 | Sheltered homelessness | Z62.819 | Personal history of childhood abuse |
| Z59.02 | Unsheltered homelessness | Z63.0 | Problems in relationship with spouse/partner |
| Z59.1 | Inadequate housing | Z63.4 | Disappearance/death of family member |
| Z59.3 | Living in residential institution | Z63.5 | Disruption of family (separation/divorce) |
| Z59.41 | Food insecurity | Z63.6 | Dependent relative needing care at home |
| Z59.48 | Other specified lack of adequate food | Z63.72 | Alcoholism/drug addiction in family |
| Z59.7 | Insufficient social
insurance/welfare support |
Z65.1 | Imprisonment/other incarceration |
| Z59.811 | Housing instability, risk of homelessness | Z65.2 | Problems related to release from prison |
| Z59.812 | Housing instability, homeless past 12 mo. | Z65.8 | Other psychosocial circumstances
(religious/spiritual) |
| Z59.819 | Housing instability, unspecified |
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
