Medicare AdvantagePrior AuthMedium impact
24-1234 Prior Authorization Requirement Change for Medicare
Health Net·PM&R (Physical Medicine & Rehab), Orthopedics, Neurology·Prior Authorization
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Wellcare By Health Net Medicare Advantage plans now require prior authorization for HCPCS code L8702 (powered upper extremity range of motion assist device) effective January 1, 2025. This affects prosthetic billing for powered elbow, wrist, hand, and finger devices with microprocessors.
Action Required
Before January 1, 2025: Billing team must update system to require prior authorization for HCPCS L8702 when billing Wellcare By Health Net Medicare Advantage plans. Contact Provider Services at 800-929-9224 or through provider portal for PA requests. Update encounter forms to alert providers. Claims submitted without prior auth will be denied.