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CommercialCoverageMedium impact

25-368 New Law Expands Protections for Survivors of Rape and Sexual Assault

Health Net·CA · Emergency Medicine, OB-GYN, Family Medicine +3 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. Claims must be billed with specific diagnosis codes to ensure proper coverage.

Action Required

Action needed
By July 1, 2025: Billing team must update system to recognize rape and sexual assault diagnosis codes for zero cost-sharing billing. Add all specified ICD-10 codes to system for automatic member cost-share waiver. Update encounter forms and EMR templates to include diagnosis code options for rape/sexual assault cases. Ensure prescriptions include relevant diagnosis codes when treating these patients.

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