CommercialBilling CodesMedium impact
22-906 Stay Compliant with No Cost-Share for Abortion Services
Health Net·CA · OB-GYN, Family Medicine·Prior Authorization
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Health Net California now prohibits cost-sharing for abortion and abortion-related services per Senate Bill 245. Providers must bill abortion-related diagnosis codes as primary/principal position to ensure zero cost-share for pre and post abortion services.
Action Required
Immediately: Billing team must update coding procedures to bill abortion-related diagnosis codes as primary/principal position on all claims for abortion services. Download the ICD-10-CM codes list (22-907) from Health Net's Provider Library at providerlibrary.healthnetcalifornia.com. Train staff to ensure pre and post abortion services use abortion-related diagnosis codes as primary to trigger zero cost-share benefits.