CommercialPrior AuthMedium impact
23-495 Prior Authorization for Echo and Stress Echo Cardiac Imaging Not Required
Health Net·CA · Cardiology, Internal Medicine, Family Medicine·Prior Authorization
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Summary
Effective July 1, 2023, HealthNet California no longer requires prior authorization for echocardiogram and stress echocardiogram cardiac imaging procedures. Billing teams can submit these claims directly without obtaining prior approval.
Action Required
By July 1, 2023: Billing team must update prior authorization workflows to remove echo and stress echo cardiac imaging from procedures requiring pre-approval. Update billing system rules and staff training materials to reflect that these cardiac imaging studies can be scheduled and billed directly without prior authorization requests to HealthNet California.