MedicaidPrior AuthMedium impact
24-025m Update to Authorization Request for Sleep Studies Effective January 5, 2024
Health Net·CA · Sleep Medicine, Pulmonology·Prior Authorization
Effective date
Jan 5, 2024
We identified it
Jun 20, 2026
Summary
Health Net California updated prior authorization requirements for facility-based sleep studies for obstructive sleep apnea, effective January 5, 2024. Providers must ensure correct coding when submitting authorization requests for these services in specific California counties.
Action Required
Immediately: Billing team must download the Provider Update PDF from Health Net California to review correct coding requirements for facility-based sleep study prior authorization requests. Update prior authorization submission procedures to ensure proper coding is used for obstructive sleep apnea sleep studies. This applies to providers in Amador, Los Angeles, Calaveras, Sacramento, Inyo, Mono, San Joaquin, Stanislaus, Tuolumne, and Tulare counties for Medi-Cal patients.