MedicaidPrior AuthHigh impact
25-843sum Summary Update: Updates to the Prior Authorization Requirements
Health Net·CA·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net has updated prior authorization requirements for Medi-Cal LA County providers, adding new CPT and HCPCS codes that will require prior authorization starting July 1, 2025, with some changes effective immediately and others on November 1, 2025.
Action Required
Immediately: Access the complete policy document 25-843 (PDF) to identify specific CPT and HCPCS codes requiring prior authorization. Review the Medi-Cal LA-DHS Prior Authorization List at the Health Net provider portal. By July 1, 2025: Update billing system and encounter forms to require prior authorization for all newly specified codes. Contact Health Net Provider Services at 800-675-6110 with questions.