CommercialPrior AuthMedium impact
25-1224 Prior Authorization Changes - Effective October 1, 2025
Health Net·CA·Prior Authorization
Effective date
Oct 1, 2025
We identified it
Jun 20, 2026
Summary
HealthNet California is implementing prior authorization changes effective October 1, 2025, with new CMS code updates. The policy requires providers to review updated prior authorization requirements that will affect billing workflows.
Action Required
Before October 1, 2025: Billing team must download and review the Provider Update PDF from HealthNet's provider library to identify specific prior authorization changes. Update billing system with new CMS code requirements and train staff on updated prior authorization workflows to prevent claim denials.