MedicaidPrior AuthMedium impact
25-605 Annual Review and Updates to the Behavioral Health Provider Operations Manual
Health Net·CA · Psychiatry·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net has completed its annual review of the Behavioral Health Provider Operations Manual for Medi-Cal, updating 8 sections including prior authorization requirements, utilization management, and level of care criteria. Billing teams serving behavioral health providers in Fresno, Kings, and Madera counties must review the updated manual for changes affecting outpatient services and higher levels of care.
Action Required
Immediately: Billing teams serving behavioral health providers must access and review the updated Behavioral Health Provider Operations Manual at the Health Net provider library, focusing on changes to prior authorization requirements (Section 9), utilization management processes (Section 10), and level of care criteria (Section 8). Contact Behavioral Health provider services at 844-966-0298 with questions. Update billing workflows and staff training based on revised requirements for outpatient services and higher levels of care.