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MedicaidAdministrativeMedium impact

24-1053 Provider Communications Posted Online and Operations Manual Updates for September 2024

Health Net·CA·Prior Authorization
Effective date
Sep 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net California posted September 2024 provider communications and operations manual updates covering various topics including balance billing prohibitions, vaccine reimbursement changes, telehealth billing requirements, and updated behavioral health contact information. Key changes include pharmacy reimbursement for ACIP-recommended vaccines and updated telehealth CPT/HCPCS coding guidance.

Action Required

Action needed
Review September 2024 provider communications at Health Net's Provider Library to understand multiple policy updates. Billing team should verify telehealth services use appropriate CPT and HCPCS codes per updated guidance. Ensure compliance with balance billing prohibition for Medi-Cal members. Update contact information for behavioral health billing inquiries per Section 2 of the Behavioral Health Provider Operations Manual.