MedicaidPrior AuthMedium impact
25-907 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 physicians to submit a Physician Certification Statement (PCS) form for all Non-Emergency Medical Transportation (NEMT) requests for Medi-Cal members, including wheelchair vans, ambulance services, and air transport. The form must be submitted to the Health Net Care Ride Unit for authorization to avoid delays in member transportation services.
Action Required
Immediately: All providers must complete and submit PCS forms to Health Net Care Ride Unit when requesting NEMT services for Medi-Cal members. Download the PCS HN Form from the Provider Library under Medi-Cal > Forms and References. Submit completed forms via fax for prior authorization. Failure to submit required forms will result in members being unable to receive transportation services until the form is received.