MedicaidPrior AuthMedium impact
22-1040m Help Members Live Independently with Personal Care and Homemaker Services
Health Net·CA · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net introduces new Personal Care and Homemaker Services for members needing help with daily living activities to avoid hospitalization or institutionalization. Billing must use service code T1019 with modifier U6 and requires prior authorization through Community Supports program.
Action Required
Immediately: Billing team must set up service code T1019 with modifier U6 in billing system for Personal Care and Homemaker Services. Configure system to require prior authorization for all T1019-U6 claims. Train staff on eligibility criteria (risk of hospitalization/institutionalization, loss of function with no support, or approved for In-Home Supportive Services). Access Health Net provider website at Healthnet.com for authorization guides. Claims without proper authorization will be denied.