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26-376m Respite Services Authorization Form Updated
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
The Respite Services Authorization Form has been updated to include required billing codes (S9125, H0045, S5151) to streamline authorization and billing processes. Providers must now select the correct billing code when requesting respite services based on the type and location of care.
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What to do
immediately · 3 steps
01Billing team must access the latest Respite Authorization Form from CalAIM Resources for Providers and update procedures to include the correct billing code when submitting respite service requests.
02Select S9125 for in-home respite care (no prior auth required), H0045 for respite care not in the home, or S5151 for unskilled respite care not hospice.
03Contact the long-term services and supports liaison with questions.
Codes mentioned
S9125H0045S5151
Original notice
26-376m Respite Services Authorization Form Updated
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
Related changes
See all Health Net changes →22-1016m Respite Services: Provide Temporary Relief for Primary CaregiversMediumNo effective date · Prior Authorization22-1017m Respite Services: Provide Temporary Relief for Primary CaregiversMediumNo effective date · Prior Authorization26-375m Respite Services Authorization Form UpdatedMediumNo effective date · Prior Authorization26-377m Respite Services Authorization Form UpdatedMediumNo effective date · Prior AuthorizationBrowse every Health Net change in the policy list