CommercialPrior AuthMedium impact
24-1000m Medical Policies - August 2024
Health Net·CA · Sleep Medicine, Pain Management, Neurology +3 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Centene/Health Net updated multiple medical policies for August 2024, including new sleep study guidelines, changes to biofeedback coverage (removing neurosound/biosound), diaphragm pacing updates, and revised criteria for nerve blocks, trigger point injections, and bone stimulation procedures.
Action Required
Immediately: Review updated prior authorization criteria for affected procedures. Billing teams should verify current requirements for sleep studies, biofeedback services (stop billing for neurosound/biosound treatments), diaphragmatic nerve stimulation, osteogenic stimulation, selective nerve root blocks (note reduced duration from 6 weeks to 4 weeks), and trigger point injections (remove radiographic guidance language). Contact Health Net Provider Services at 844-966-0298 for behavioral health questions or use the provider portal for clarification on specific cases.