MedicaidPrior AuthMedium impact
24-024m 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
HealthNet California updated prior authorization requirements for sleep studies effective January 5, 2024, emphasizing the need to use correct coding for facility-based sleep studies for obstructive sleep apnea. This policy specifically applies to Medi-Cal members in Fresno, Kings, and Madera counties.
Action Required
Immediately: Billing team must review and verify correct CPT/HCPCS codes are being used when submitting prior authorization requests for facility-based sleep studies for obstructive sleep apnea patients. Download the Provider Update PDF from HealthNet's provider library to obtain specific coding requirements. Update authorization request templates and staff training for Medi-Cal patients in Fresno, Kings, and Madera counties.