MedicaidPrior AuthMedium impact
24-1320 Action Needed: Request Prior Authorization for NEMT and Submit PCS Forms Directly to Health Net for Medi-Cal Members
Health Net·CA·Prior Authorization
Effective date
Mar 1, 2025
We identified it
Jun 20, 2026
Summary
Starting March 1, 2025, Medi-Cal members must contact providers (not Modivcare) to request NEMT services, and providers must submit completed PCS forms directly to Health Net at 833-701-0051 for prior authorization. NEMT now requires prior authorization from Health Net's Care Ride Unit for all non-emergency medical transportation including ambulances, wheelchair vans, and gurney vans.
Action Required
By March 1, 2025: Front desk staff must inform Medi-Cal members to contact the practice (not Modivcare) for transportation requests. Providers must complete and sign PCS forms for members requesting medical transportation and fax to Health Net at 833-701-0051 for prior authorization. Download updated PCS forms from Health Net Provider Library starting March 1, 2025. Do not send forms to Modivcare. Contact CalViva Health at 888-893-1569 with questions.