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MedicaidCoverageMedium impact

25-367 New Law Expands Protections for Survivors of Rape and Sexual Assault

Health Net·CA · Emergency Medicine, OB-GYN, Psychiatry +2 more·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Effective July 1, 2025, Health Net will cover emergency room care, follow-up medical treatment, and mental health services for rape and sexual assault survivors with no member cost sharing. Billing teams must use specific diagnosis codes when billing for these services to ensure proper coverage.

Action Required

Action needed
Before July 1, 2025: Billing team must update coding procedures to include appropriate rape/sexual assault diagnosis codes on all claims for related services. Update encounter forms and EMR templates with the specific ICD-10 codes provided. Train providers to include relevant diagnosis codes on prescriptions for member care. Claims without proper diagnosis codes may not receive the mandated cost-sharing elimination.

Affected Billing Codes

T7421XA
T7421XD
T7421XS
T7422XA
T7422XD
T7422XS
T7621XA
T7621XD
T7621XS
T7622XA
T7622XD
T7622XS
Z0441
Z0442
T745
T7451
T7451XA
T7451XD
T7451XS
T7452
T7452XA
T7452XD
T7452XS
Z0481
T7651
T7651XA
T7651XD
T7651XS
T7652
T7652XA
T7652XD
T7652XS