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MedicaidPrior AuthMedium impact

26-375m Respite Services Authorization Form Updated

Health Net·CA · Palliative Care·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

The Respite Services Authorization Form has been updated to include specific billing codes (S9125, H0045, S5151) that must be selected when requesting respite services. This change streamlines authorization and billing processes for Community Supports providers in specific California counties.

Action Required

Action needed
Immediately: Billing team must access the updated Respite Services Authorization Form from CalAIM Resources for Providers and update procedures to select the appropriate billing code when submitting respite service requests: S9125 for in-home respite care (no prior auth needed), H0045 for respite care not in the home, or S5151 for unskilled respite care not hospice. Update staff training on proper code selection to ensure accurate processing and avoid delays.

Affected Billing Codes

S9125
H0045
S5151