MedicaidPrior AuthMedium impact
25-1178m Updated Authorization Guides: Personal Care and Homemaker Services and Day Habilitation Services
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net California updated authorization guides for Personal Care/Homemaker Services and Day Habilitation Services to align with DHCS standards. Key changes include Day Habilitation authorization periods extended to up to 90 days, billing unit changed from per diem to per hour, and a new referral form is required.
Action Required
Immediately: For Day Habilitation Services, billing team must update system to change authorization unit from per diem to per hour billing. Providers must begin using the new Day Habilitation Referral Form (PDF) for all eligible member referrals. Update authorization request processes to reflect new 90-day maximum periods for initial authorizations and extensions. Download updated forms from CalAIM Resources for Providers page under Forms & Tools > Community Supports (CS).