MedicaidPrior AuthMedium impact
25-477m Learn Which Anesthesia and Facility Fees are PPG Responsibility for Dental Procedures
Health Net·CA · Dentistry·Provider News
Effective date
May 23, 2025
We identified it
Jun 20, 2026
Summary
HealthNet California has issued new guidance for Participating Physician Groups (PPGs) on processing anesthesia and facility fees for dental procedures in Imperial County Medi-Cal. PPGs must use DHCS charts to determine who processes prior authorizations and payments for these fees.
Action Required
By May 23, 2025: Billing teams at PPGs must download and review the DHCS charts from the Provider Update PDF to determine proper processing responsibilities for anesthesia and facility fee prior authorizations and payments for dental procedures. Update billing workflows to follow the correct authorization and payment routing for Imperial County Medi-Cal dental cases.