Provider Time and Distance Standards

Provider time and distancing standards have been put in place the Department of Health Care Services (DHCS) to ensure that all Medi-Cal members have equal access to health care.
Time and distance means the number of minutes and miles from the member's home residence when traveling to the provider's medical office.

The standards apply to these types of providers:

  • Primary Care Doctor (adult and pediatric)
  • Specialty Care Doctor (adult and pediatric)
  • Behavioral health (including mental health and substance use disorder treatment)
  • OB/GYN
  • Hospital
  • Pharmacy
  • Pediatric dental
  • Long-term services and support (LTSS)

Check out the specific time and distancing standards per type of providers: Provider Time and Distance Standards

When does a health plan not comply with the standards?

These time and distancing standards set by DHCS are harder to achieve in more rural areas.  When a provider is not available within the time and distance needed, CHG applies for an exception to the standard.  These exceptions are then reviewed by DHCS and all approved ones can be found here:

CHG list of DHCS approved alternate time and distance standards

What if my zip code is in a rural area?

If your zip code and provider type are listed in the exceptions, CHG can help you find an appointment. You have a right to call our Member Services Agents 24/7 at 1-800-224-7766 to get help with finding an appointment to a closer specialist, CHG can arrange transportation to see the specialist.