Medicare AdvantageAdministrativeMedium impact
25-667 Provider Communications Posted Online and Operations Manual Updates for June 2025
Health Net·CA·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net California published its June 2025 provider communications summary, highlighting key updates including new dyadic care services reimbursement for Medi-Cal, updated prior authorization forms with behavioral health options, and revised diagnosis code placement requirements for rape/sexual assault-related prescriptions. Multiple operational manual updates affect billing procedures across different plan types.
Action Required
By July 1, 2025: Billing team must update ICD-10 code placement procedures for prescriptions related to rape and sexual assault per Assembly Bill 2843. Use updated Commercial and Medicare prior authorization forms that include behavioral health options and new fax instructions. Review updated Injectable Medication HCPCS/DOFR Crosswalk for Q1 2025. Update Community Supports authorization processes for Medi-Cal patients using new guides and referral forms.