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24-029m Follow Prior Authorization Requirements to Submit Palliative Care Requests
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Medi-Cal now requires prior authorization for all palliative care services using specific codes and contracted providers. Billing teams must submit prior authorization requests with medical records for members with advanced acute illness before providing palliative care services.
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What to do
immediately · 6 steps
01Billing team must obtain prior authorization before billing palliative care services for Medi-Cal members.
02Use diagnosis code Z51.5 and procedure code S0311 with 6 units (6 months) on prior authorization requests.
03Select contracted providers from the Palliative Care Contracted Providers list in Provider Library.
04Submit completed Outpatient California Medi-Cal Prior Authorization form with medical records to fax 800-743-1655.
05Standard requests take 5 business days, urgent requests 72 hours.
06Claims will be denied without proper prior authorization.
Codes mentioned
Z51.5S0311
Original notice
24-029m Follow Prior Authorization Requirements to Submit Palliative Care Requests
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
Related changes
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