MedicaidBilling CodesMedium impact
24-588 Expanded Prenatal Screening Program
Health Net·CA · OB-GYN, Family Medicine·Prior Authorization
Effective date
Apr 1, 2024
We identified it
Jun 20, 2026
Summary
California's Prenatal Screening Program has expanded to include sex chromosome aneuploidy screening (X, XXY, XYY, XXX) in addition to existing trisomy screening. Billing teams must use updated CPT code 81420 for the expanded screening panel and ensure they use California PNS Program-contracted labs for coverage under Medi-Cal, while Commercial plans can use any contracted lab.
Action Required
Immediately: Update billing system to use CPT code 81420 for expanded prenatal screening that includes sex chromosome aneuploidy. Ensure staff uses California PNS Program-contracted labs for Medi-Cal patients and the required PNS Program referral form. Update encounter forms to include diagnosis code Z360 for antenatal screening. For Commercial plans, remind staff that using PNS Program labs eliminates copays and prior authorization requirements.