MedicaidPrior AuthMedium impact
25-465m Help Members More Easily Access Non-Specialty Mental Health Services
Health Net·CA · Psychiatry, Family Medicine, Internal Medicine +2 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health updated their non-specialty mental health services policy to eliminate prior authorization requirements for most outpatient mental health services including office visits with therapists, psychiatrists, and other behavioral health professionals. Members can now self-refer to mental health providers without prior authorization.
Action Required
Immediately: Billing team must update systems to remove prior authorization requirements for non-specialty mental health outpatient services including therapy and psychiatry visits for CalViva Health members. Update encounter forms and staff training to reflect that members can self-refer without prior auth. Inform providers they can refer members to CalViva's behavioral health provider directory or Teladoc services.