MedicaidAdministrativeMedium impact
25-668 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 a comprehensive summary of provider communications and operations manual updates for June 2025, covering multiple areas including dyadic care services reimbursement, updated medical policies, new billing guidelines for rape/sexual assault prescriptions, and community supports authorization updates. Most changes have effective dates in July 2025.
Action Required
By July 1, 2025: Billing team must review and implement multiple changes: 1) Update ICD-10 code placement procedures for prescriptions related to rape and sexual assault per AB 2843 requirements, 2) Review updated Community Supports authorization guides and referral forms for new eligibility criteria and documentation requirements, 3) Update injectable medication billing using the revised HCPCS/DOFR Crosswalk for Q1 2025, 4) Review May 2025 medical policy changes for coverage determinations. Front desk staff should note availability of dyadic care services at Medi-Cal FFS rates for FQHCs, RHCs, and Tribal Health Programs.