← Back to list
24-028m Follow Prior Authorization Requirements to Submit Palliative Care Requests
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
New prior authorization requirements established for palliative care services for Medi-Cal members in Imperial County. Billing teams must submit prior authorization requests with specific diagnosis code Z51.5, procedure code S0311, and supporting medical records before providing palliative care services.
Get alerts when payers change rules like this one
We check Health Net and other payers every day and email you when a change matches your specialty and state.
Get Health Net alertsPolicy Monitoring is free. No card required.
What to do
immediately · 4 steps
01Billing team must implement prior authorization workflow for palliative care requests using diagnosis code Z51.5 and procedure code S0311 (6 units for 6 months).
02Complete Outpatient California Medi-Cal Prior Authorization form with medical records documenting advanced acute illness.
03Select contracted provider from approved list and fax to 800-743-1655 (833-769-1141 for transplants).
04Allow 5 business days for standard requests, 72 hours for urgent requests.
If missed: Failure to obtain prior authorization will result in claim denials.
Codes mentioned
Z51.5S0311
Original notice
24-028m Follow Prior Authorization Requirements to Submit Palliative Care Requests
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
Related changes
See all Health Net changes →24-027m Follow Prior Authorization Requirements to Submit Palliative Care RequestsMediumNo effective date · Prior Authorization24-029m Follow Prior Authorization Requirements to Submit Palliative Care RequestsMediumNo effective date · Prior AuthorizationBrowse every Health Net change in the policy list