Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Health NetMedicaid · Coverage · Prior Authorization · CA · Cardiology, Neurology, Pulmonology +7 moreHigh impact

20-712 Medical Policies - 2nd Quarter 2020

Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

CalViva Health updated medical policies for Q2 2020 affecting Medi-Cal members in Fresno, Kings, and Madera counties. Multiple policies were added or revised with new coverage criteria, code updates, and prior authorization requirements for various procedures including burn surgery, cardiac rehabilitation, genetic testing, and COVID-19 diagnostics.

Get alerts when payers change rules like this one

We check Health Net and other payers every day and email you when a change matches your specialty and state.

Get Health Net alertsPolicy Monitoring is free. No card required.

What to do

immediately · 5 steps
01Billing team must review and update prior authorization requirements for all affected procedures listed in the policy.
02Update billing software with new CPT codes for ambulatory EEG (95700, 95705, 95708, 95717, 95719, 95721, 95723, 95725) and mechanical stretching device HCPCS codes (E1800, E1802, E1805, E1810, E1812).
03Stop billing CPT codes 20560 and 20561 for trigger point injections as they no longer support coverage criteria.
04Add COVID-19 diagnostic codes U07.1 and U07.2 to system.
05Contact CalViva Health at 1-888-893-1569 for questions about specific policy requirements.

Codes mentioned

95700957059570895717957199572195723957259091290913J80J96.01U07.1U07.2E1800E1802E1805E1810E18122056020561

Original notice

20-712 Medical Policies - 2nd Quarter 2020
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
View original ↗

Related changes

See all Health Net changes →
20-709 Medical Policies - 2nd Quarter 2020HighNo effective date · Prior Authorization20-711 Medical Policies - 2nd Quarter 2020HighNo effective date · Prior Authorization26-073 Updates to the Prior Authorization RequirementsHighEffective Apr 1, 2026 · Prior Authorization26-074 Updates to the Prior Authorization RequirementsHighEffective Apr 1, 2026 · Prior AuthorizationBrowse every Health Net change in the policy list

Related policy hubs

Health Net policiesCA policy changesCardiologyNeurologyPulmonologyPlastic SurgeryGeneral SurgeryPain ManagementCritical CarePediatricsGastroenterologyEndocrinologyCode 95700Code 95705Code 95708Code 95717Code 95719Code 95721Code 95723Code 95725Code 90912Code 90913Code J80Code J96.01Code U07.1Code U07.2Code E1800Code E1802Code E1805Code E1810Code E1812Code 20560Code 20561

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account