Strategic Partnership
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CalAIM Asthma Remediation & Community Support
StratiHealth™ operates as a direct contracting partner delivering CalAIM Asthma Remediation Community Support services across California. Our comprehensive framework pairs clinical management with tailored environmental interventions—eliminating indoor triggers, distributing HEPA air filtration equipment, and providing key home modifications for eligible Medi-Cal beneficiaries.
Through direct partnerships with Managed Care Plans (MCPs), we streamline referral-to-delivery workflows. Our specialized team coordinates directly with health plans, healthcare providers, and local community organizations to ensure timely remediation, reducing emergency room visits and improving long-term health outcomes.
State Directives & Sources
Official California Department of Health Care Services Documentation
DHCS ECM and Community Supports
Official guidelines and operational framework for CalAIM Enhanced Care Management and Community Supports programs.
DHCS Community Supports: Select Service Definition Updates, Feb 2025
Latest service definitions and technical updates covering environmental remediation and home safety modifications.
The Asthma Remediation Journey
Watch how our in-home environmental remediation program and Chest Clinics identifies asthma triggers, delivers targeted health interventions by using Remote Patient Monitoring and wearable devices, and empowers families with long-term care support.
Asthma Remediation — Member Journey
From Medi-Cal MCP referral to in-home remediation, RPM enrollment, and outcome reporting — built on the DHCS Asthma Remediation Community Support service definition.
MCP Referral & Case Identification
Identifies an enrolled Medi-Cal member with asthma in a county where Asthma Remediation has been elected; submits the referral via the StratiHealth™ secure portal.
Intake team confirms County election, MCP contract scope, and the member's lifetime $7,500 cap status; opens a CalAIM Community Support case file.
Eligibility & Authorization
Confirms Asthma Preventive Services (APS) in-home trigger assessment exists in the prior 12 months — from Jan 1, 2026 onward no further medical-appropriateness sign-off is required to authorize.
Issues member welcome packet, assigns a bilingual care coordinator, schedules the first in-home visit, and confirms the requesting provider.
Member Outreach & Consent
Issues encounter authorization for the Community Support; tags the member for CalAIM IPP reporting and HEDIS asthma cohort tracking.
Care coordinator calls in the member's preferred language, confirms visit window, obtains verbal consent for in-home services, and completes intake forms.
In-Home Environmental Trigger Assessment (APS benefit)
Reimburses the assessment and asthma self-management education under the new statewide Asthma Preventive Services (APS) benefit — separate from the $7,500 remediation cap.
A California-licensed Registered Respiratory Therapist (RRT/RCP) walks the home: identifies mold, pests, dust, humidity, ventilation gaps; documents medically appropriate interventions.
RRT Clinical Evaluation & Pulmonologist Oversight
Approves physician-prescribed respiratory-care visits under CMS LCD L34149; logs the prior authorization for downstream claims.
RRT delivers peak-flow training, inhaler/spacer technique check, asthma action-plan review, medications reconciliation. Pulmonologist reviews comorbidities and sets the escalation pathway.
Supplies & Physical Modifications Delivered
Approves the itemized remediation list against the $7,500 lifetime cap; pays the encounter under the in-lieu-of Asthma Remediation CS rate.
A California-licensed contractor delivers: allergen-impermeable encasings, HEPA vacuum, dehumidifier, mechanical air filter, IPM, moisture/mold remediation, ventilation improvements; RRT confirms proper setup.
RPM & CCM Enrollment (Billing-Defensible Wraparound)
Reimburses RPM under CPT 99453 / 99454 / 99457 / 99458 and CCM under CPT 99490 / 99439 (or 99491 / 99437 for physician-led complex CCM) when CMS clinical criteria are met.
Pulmonologist designs the RPM plan (peak-flow, SpO2, adherence); RRT provisions devices, trains the member, and enrolls the member in CCM if asthma coexists with a second chronic condition.
Follow-up, RPM Data Review & Outcome Reporting
Receives encounter data, ACT-score deltas, and ED/IP utilization; closes CalAIM IPP attestation and HEDIS asthma cohort updates.
RRT 30-day and 90-day in-home reassessment; pulmonologist reviews RPM data and steps therapy as needed; member-care plans are updated and submitted to the MCP encounter format.
Reference & Compliance Note:
StratiHealth™ • CalAIM Asthma Remediation Community Support • Sources: DHCS Community Supports Service Definition Updates (Feb 2025); DHCS MCP Election Tracker (June 2026); CMS LCD L34149; CMS RPM & CCM policies.
Ready to streamline your CalAIM Asthma Remediation process?
Partner with StratiHealth™ to deliver high-quality in-home environmental trigger remediation, clinical oversight, and defensible RPM integration.
Three Ways to Engage
Select the engagement path tailored to your organization to streamline contracting, expand provider networks, or launch new county programs.
Schedule a contracting call with our MCP / DHCS team
Apply as a subcontracted CS expert provider
Request a county feasibility study
Compliance, Authorizations and Billing Alignment
Service-Definition Compliance
Our clinical remote monitoring and care management programs are structured to meet strict CMS guidelines. Every protocol aligns with standardized care definitions, ensuring seamless integration with existing electronic health record systems.
MCP Contracting Mechanism
We partner directly with Managed Care Plans (MCPs) and provider organizations through direct contracting mechanisms, value-based care frameworks, and risk-sharing models designed to optimize administrative efficiency.
Authorization (post-January 1, 2026)
In compliance with updated CMS mandates effective January 1, 2026, prior authorization processes for remote patient monitoring and chronic care management are streamlined via automated electronic verification workflows.
| CPT Code | Description |
|---|---|
| 99453 | Initial set-up and patient education on equipment transmission. |
| 99454 | Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days. |
| 99457 | Remote physiological monitoring treatment management services, first 20 minutes per calendar month. |
| 99458 | Remote physiological monitoring treatment management services, each additional 20 minutes per calendar month. |
| CPT Code | Description |
|---|---|
| 99490 | Chronic care management services, first 20 minutes of clinical staff time per calendar month. |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month. |
| 99491 | Chronic care management services provided personally by a physician or QHP, first 30 minutes per calendar month. |
| 99437 | Chronic care management services provided personally by a physician or QHP, each additional 30 minutes per calendar month. |
Regulatory Note: Source: CMS CY 2024 PFS Final Rule. Reimbursement rates and clinical criteria remain subject to regional Medicare Administrative Contractor (MAC) policies and plan-specific agreements.
Flexible Contracting Tracks
Choose the contracting arrangement that best fits your operational infrastructure, licensing model, and strategic objectives under CalAIM.
Establish direct contractual agreements with Managed Care Plans (MCPs) and the Department of Health Care Services (DHCS) for turnkey CalAIM execution.
What this track looks like
- Direct billing and credentialing setup under DHCS standards
- End-to-end Enhanced Care Management (ECM) and Community Supports pathway integration
- Dedicated compliance, quality auditing, and risk management oversight
- Scalable clinical workflows customized for health plan specifications
Healthcare organizations, medical groups, and large community partners aiming to directly manage plan contracts, capture full capitation rates, and control end-to-end CalAIM program delivery.
Partner as an expert subcontracted network provider to deliver specialized clinical programs with turnkey operational support.
What this track looks like
- Licensed Respiratory Care Practitioners (RCPs) and specialist clinical team
- Board-certified pulmonologist oversight and specialized medical direction
- Integrated Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) infrastructure
- 100% California-licensed clinical execution and regulatory compliance
- Joint progress reporting, health equity tracking, and outcome analytics
- Optional white-label back-office administration and billing workflow support
Existing Managed Care Plan providers, IPAs, and clinical organizations looking to rapidly launch high-complexity respiratory and specialized CalAIM CS programs without heavy administrative overhead.
Why Asthma Remediation, and Why Now
Two DHCS policy shifts in 2025–2026 directly affect program economics for MCPs and provider networks.
Refined eligibility criteria, simplified authorization workflows, and clarified covered supplies ensure faster deployment and higher reimbursement reliability.
- Refined eligibility criteria
- Simplified authorization process
- Clarified covered environmental supplies
Establishes structured split billing rules alongside a defined $7,500 lifetime cap per beneficiary, with specific clinical exception pathways.
- Structured split billing protocols
- $7,500 lifetime beneficiary cap
- Defined clinical exception workflows
Creates sustainable revenue streams for Medi-Cal Managed Care Plans (MCPs) while directly bridging funding gaps for Community-Based Organizations (CBOs).
- Sustainable MCP revenue stream
- CBO gap remediation & funding
- Accelerated care delivery scaling
DHCS Feb 2025 service-definition update.
Service Area
Asthma Remediation has been elected by 24+ Medi-Cal MCPs across all 58 California counties, delivering high-impact environmental in-home interventions where patients need them most.
Expansion Inquiries
Don't see your county? Talk to us about expansion.
Bay Area, Sacramento metro, and northern coastal communities.
Agricultural centers and central coastal health networks.
Major metropolitan healthcare districts and surrounding regions.
Dedicated access routes for mountain, desert, and remote communities.
What We Report to the MCP
Our automated reporting framework supports 837p, 837i, and custom flat-file encounter format configurations to meet all Managed Care Plan compliance standards.
Members Enrolled per Month per County
Structured monthly tracking of active member enrollment, categorized by county and service area.
Average Time from Referral to First Visit
Turnaround benchmarks measured from initial outreach transmission to in-person home visit completion.
Itemized Goods & Environmental Modifications
Full line-item documentation for all delivered physical supplies, products, and home modifications.
Asthma-Related ED/IP as HEDIS Trigger
Real-time event capture and emergency department/inpatient hospitalization tracking aligned with HEDIS measures.
30- and 90-Day Post-Remediation Reassessment
Standardized evaluation timelines to verify sustained environmental remediation outcomes and compliance.
Member ACT Score Intake and 90-Day
Comparative Asthma Control Test (ACT) scoring captured at baseline intake and following 90 days of care.
Frequently Asked Questions
Everything you need to know about CalAIM readiness, contract execution, and health plan integration for your organization.
Our healthcare contracting specialists are ready to help you navigate plan requirements and application workflows.
Contact Our SpecialistsOur Clinical Team
Asthma Remediation fails on outcomes when delivered by non-clinical labor. Our multidisciplinary governance model pairs certified clinical expertise with localized outreach to drive sustained quality and compliance.
Highly qualified clinical respiratory specialists executing home assessment protocols, targeted airway evaluations, and personalized asthma self-management education.
Board-certified pulmonary physicians overseeing Remote Patient Monitoring telemetry, reviewing respiratory trends, and making timely clinical interventions.
Expert pulmonary specialists directing Chronic Care Management plans, ensuring multidisciplinary coordination, and stabilizing high-risk pediatric and adult patients.
Fully credentialed and state-licensed healthcare contractors delivering compliant, localized clinical oversight and home remediation governance.
Bilingual care coordinators supporting members in multiple languages across the counties we serve to ensure accessible and culturally competent care.
All clinical operations, Remote Patient Monitoring (RPM), and Chronic Care Management (CCM) workflows strictly adhere to statutory state scope-of-practice standards and Medicare billing guidelines.
Clinical Services & Operational Delivery
What StratiHealth™ delivers — every DHCS-allowable service component, plus clinical oversight that turns remediation into a measurable clinical outcome.
- Comprehensive environmental assessment and home modification planning
- HEPA air purifiers and replacement filters (note: electronic air filters excluded per DHCS guidelines)
- Allergen-impermeable mattress and pillow encasements
- Vacuum cleaners with certified HEPA filtration
- Dehumidifiers for moisture control in high-humidity zones
- Pest eradication supplies and integrated pest management coordination
- Minor structural modifications (window screens, weather stripping, door sweeps)
- Non-toxic cleaning product kits for mold and dust suppression
- Respiratory Care Practitioner (RCP) scope-of-practice clinical evaluations
- Alignment with CMS LCD L34149 clinical coverage criteria for respiratory care
- Tailored asthma and COPD trigger remediation protocols
- Individualized patient education and inhaler technique validation
Regulatory & Scope Guidance
- Remote Patient Monitoring (RPM) cellular-enabled device provisioning
- Daily digital peak-flow meter and SpO2 telemetry tracking
- CPT 99457 and 99458 clinical care management time and interaction logging
- Chronic Care Management (CCM) CPT 99490 and 99439 clinical workflow integration
- California-licensed clinician oversight for all care plans
- Timely 837i and 837p encounter data generation and transmission
- Complete DHCS-compliant outcome and compliance reporting
- Seamless CalAIM ECM and Community Supports billing integration
Ready to integrate comprehensive DHCS services?
Partner with StratiHealth™ to deliver full-scope remediation and licensed respiratory care management across California.