CommercialPrior AuthHigh impact
25-842sum 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 California has updated prior authorization requirements with new CPT and HCPCS codes effective July 1, 2025, plus immediate additions and changes to existing requirements. The billing team must review the complete policy document 25-842 to identify which specific codes now require prior authorization.
Action Required
Immediately: Billing team must access the complete policy document 25-842 from Health Net's Provider Library to identify all new CPT and HCPCS codes requiring prior authorization. Update billing system rules for codes effective July 1, 2025, and review immediate additions and changes. Update encounter forms and staff training to ensure prior authorization is obtained before services are rendered. Claims will be denied without proper prior authorization.