MedicaidPrior AuthMedium impact
25-1204 Respite Services Made Easier: New Authorization Guide and Form Streamline Support for Caregivers
Health Net·CA·Prior Authorization
Effective date
Dec 1, 2025
We identified it
Jun 20, 2026
Summary
Effective December 1, 2025, HCPCS code S9125 for respite services no longer requires prior authorization for Community Health Plan of Imperial Valley (Medi-Cal). New authorization guides and forms will be available to streamline the referral process for remaining respite services.
Action Required
By December 1, 2025: Billing team must update system to remove prior authorization requirement for HCPCS code S9125 for Community Health Plan of Imperial Valley Medi-Cal patients. Download updated Respite Services Authorization Guide and Authorization Form from CalAIM resources page > Community Supports > Forms & Tools. Update encounter forms and billing workflows to reflect no prior auth needed for S9125.