MedicaidPrior AuthMedium impact
25-1203 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 CalViva Health Medi-Cal members. 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 CalViva Health Medi-Cal patients in Fresno, Kings, and Madera counties. Download updated Respite Services Authorization Guide and Form from CalAIM resources page. Update encounter forms and staff workflows to reflect no prior auth needed for S9125.