MedicaidPrior AuthMedium impact
25-909 Action Needed: Submit a PCS Form for NEMT for Medi-Cal Members
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net now requires a Physician Certification Statement (PCS) form for Non-Emergency Medical Transportation (NEMT) services for Medi-Cal members in Imperial County. This form must be submitted to the Health Net Care Ride Unit for authorization before transportation services like wheelchair vans, stretcher vans, or ambulances can be provided.
Action Required
Immediately: All providers must complete and submit PCS forms to Health Net Care Ride Unit before ordering NEMT services for Medi-Cal members. Download the PCS CHPIV Form from the Provider Library under Medi-Cal > Forms and References. Refer to flyer 25-753 to identify which transportation services require prior authorization. Failure to submit completed forms will delay member transportation and impact patient care.