Medicare AdvantagePrior AuthMedium impact
22-077 Medical Policies - 4th Quarter 2021
Health Net·CA · Gastroenterology, Oral & Maxillofacial Surgery, Orthopedics +6 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net has updated multiple medical policies affecting prior authorization requirements, coverage criteria, and billing codes. Key changes include new policies for gastrointestinal pathogen testing, orthognathic surgery, and osteogenic stimulation, plus updates to existing policies for ambulatory surgery centers, epidural injections, and other procedures.
Action Required
Within 60 days: Review all updated medical policies on the Health Net provider portal. Update prior authorization workflows for new policies CP.MP.209, CP.MP.202, and CP.MP.194. Verify ambulatory surgery center eligibility now includes pregnancy cases and CPT codes 66982, 66984. Contact Health Net Provider Services at 1-800-641-7761 with questions about policy changes.