All PlansAdministrativeMedium impact
25-561 Ensure Prompt Claims Payments with the Right Emergency Code Modifiers
Health Net·CA·Reimbursement
Effective date
Aug 6, 2025
We identified it
Jun 20, 2026
Summary
Health Net requires providers in Los Angeles and Ventura counties affected by Southern California wildfires to add emergency code modifiers (CR or DR) to claims starting August 6, 2025. This policy also extends claim submission deadlines to 365 days from date of service for disaster-impacted providers.
Action Required
By August 6, 2025: Billing team must update claim submission procedures to include CR modifier (Catastrophe/Disaster Related) or DR condition code (Disaster Relief) on all claims for providers in Los Angeles and Ventura counties affected by Southern California wildfires. Update billing software to prompt for these modifiers when appropriate. Claims without proper emergency modifiers may experience processing delays.