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Health NetMedicaid · Coverage · Prior Authorization · CA · Pediatrics, Family Medicine, UrologyMedium impact

22-983 Extended Benefit Coverage for Newborn Circumcision

Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

CalViva Health has extended Medi-Cal coverage for newborn circumcision from 28 days to 30 days of age, aligning with AAP recommendations. CPT codes 54150 and 54160 for newborn circumcision no longer require separate medical indication for infants 30 days and younger.

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What to do

immediately · 2 steps
01Billing team must update system parameters to allow coverage for CPT codes 54150 and 54160 for newborns up to 30 days of age (previously 28 days) for Medi-Cal patients in Fresno, Kings, and Madera counties.
02No separate medical indication documentation is required for these procedures within the extended age range.

Codes mentioned

5415054160

Original notice

22-983 Extended Benefit Coverage for Newborn Circumcision
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
View original ↗

Related changes

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22-984 Extended Benefit Coverage for Newborn CircumcisionMediumNo effective date · Prior AuthorizationBrowse every Health Net change in the policy list

Related policy hubs

Health Net policiesCA policy changesPediatricsFamily MedicineUrologyCode 54150Code 54160

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