CommercialPrior AuthHigh impact
25-327sum Summary Update: Updates to the Prior Authorization Process, and New and Upcoming Requirements Changes
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Health Net California has updated their prior authorization process with new submission options (fax, online portal, phone) and specific contact numbers for different plan types. New CPT and HCPCS codes will require prior authorization starting January 1, 2025, with additional changes rolling out on April 1 and June 15, 2025.
Action Required
Immediately: Update Health Net prior authorization contact information in billing systems and staff reference materials with new phone numbers and fax options by plan type. By January 1, 2025: Monitor for forthcoming provider updates about specific CPT and HCPCS codes that will require prior authorization. Access updated prior authorization requirements lists via Health Net Provider Library or Prior Authorizations page. Billing team must verify prior auth status for all Health Net procedures starting January 1 to avoid claim denials.