MedicaidPrior AuthMedium impact
22-1039m Help Members Live Independently with Personal Care and Homemaker Services
Health Net·CA · Family Medicine, Internal Medicine, General Practice·Prior Authorization
We identified it
Jun 20, 2026
Summary
New prior authorization policy for Personal Care and Homemaker Services using billing code T1019 with modifier U6. Members must meet specific eligibility criteria including risk for hospitalization/institutionalization or loss of function with no support system.
Action Required
Immediately: Update billing system to use service code T1019 with modifier U6 for all Personal Care and Homemaker Services. Verify member eligibility and obtain prior authorization through CalViva Health at 888-893-1569 before providing services. Access authorization guides at Healthnet.com provider portal.