Medicare AdvantagePrior AuthMedium impact
21-412 See What News is Online for May 2021
Health Net·CA · Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab)·Prior Authorization
We identified it
Jun 20, 2026
Summary
This is a news digest containing multiple Health Net policy updates from May 2021, including a key prior authorization requirement for outpatient therapy visits after 12 combined sessions, a provider satisfaction survey announcement, Medi-Cal reward program information, and ADT data submission requirements for hospitals.
Action Required
Immediately: Update billing workflow to ensure prior authorization is obtained for all outpatient physical, occupational, and speech therapy visits after the 12th combined visit. Train front desk staff to track therapy visit counts across all three modalities. Configure practice management system to alert when patients approach 12 visits to prevent claim denials.