MedicaidPrior AuthHigh impact
25-326sum 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 Medi-Cal has updated their prior authorization process with new CPT and HCPCS codes requiring prior auth effective January 1, 2025, with additional changes coming April 1 and June 15, 2025. The policy confirms three submission methods (fax, online portal, phone) and references upcoming communications for specific procedure requirements.
Action Required
Immediately: Review the complete policy update 25-326 PDF and access the Medi-Cal LA-DHS Prior Authorization List at Health Net's Prior Authorizations page. Billing team must prepare for new CPT and HCPCS codes requiring prior auth effective January 1, 2025, with additional changes April 1 and June 15, 2025. Monitor for forthcoming provider updates detailing specific procedures and services. Ensure staff know the three submission methods: fax to 800-743-1655, online portal, or phone 800-675-6110.