MedicaidPrior AuthMedium impact
23-1238 Prior Authorization Changes Effective January 1, 2024
Health Net·CA · Oncology, Neurology, Nephrology +2 more·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal is expanding prior authorization requirements effective January 1, 2024, adding 8 new HCPCS injection codes and requiring prior auth for long-term care nursing facility admissions for pediatric members under 21. This applies specifically to Los Angeles County Department of Health Services providers.
Action Required
Immediately: Update billing system to require prior authorization for HCPCS codes C9155, C9157, J0801, J0802, J0889, J2781, J9051, J9064, and J9345 for Health Net Medi-Cal LA-DHS members. Add prior auth requirement for long-term care nursing facility admissions for pediatric members under age 21. Contact Health Net at 800-453-3033 or fax 855-851-4563 for prior authorization requests. Claims will be denied without proper prior authorization.