MedicaidPrior AuthMedium impact
22-085 Major Organ Transplant is a Covered Benefit by the Health Plan
Health Net·CA · General Surgery, Cardiothoracic Surgery, Nephrology +3 more·Prior Authorization
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
CalViva Health (Medi-Cal) now covers major organ transplants for recipients and donors, including all related services like organ procurement and living donor care, effective January 1, 2022. All transplant services require prior authorization through CalViva Health's Transplant Team.
Action Required
Immediately: For all major organ transplant services in Fresno, Kings, and Madera counties Medi-Cal patients, billing team must obtain prior authorization by faxing requests to CalViva Health Transplant Team at 833-769-1141 using the Outpatient California Medi-Cal Prior Authorization Form. Contact CalViva Health at 888-893-1569 for transplant questions. Claims will be denied without proper prior authorization.