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Health NetCommercial · Coverage · Prior Authorization · CA · Pain Management, Gastroenterology, Pediatrics +10 moreHigh impact

20-709 Medical Policies - 2nd Quarter 2020

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

Summary

Health Net updated 24 medical policies in Q2 2020, including new prior authorization requirements for burn surgery and skin substitutes, coverage changes for various procedures, and updated billing codes for multiple specialties. Key changes include new COVID-19 testing guidelines, updated ADHD assessment criteria, and revised coverage for mechanical stretching devices.

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What to do

immediately · 6 steps
01Billing team must review all 24 updated policies on Health Net's provider portal under Medical Policies.
02Update prior authorization requirements for burn surgery and skin substitutes for chronic wounds.
03Verify coverage criteria for investigational procedures like radiofrequency ablation of uterine fibroids.
04Update billing system 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).
05Remove trigger point injection codes 20560 and 20561 from coverage.
06Contact appropriate Health Net Provider Services Center within 60 days with questions or claims may be denied.

Codes mentioned

95700957059570895717957199572195723957259091290913J80J96.01U07.1U07.2E1800E1802E1805E1810E18122056020561

Original notice

20-709 Medical Policies - 2nd Quarter 2020
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
View original ↗

Related changes

See all Health Net changes →
20-711 Medical Policies - 2nd Quarter 2020HighNo effective date · Prior Authorization20-712 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 changesPain ManagementGastroenterologyPediatricsNeurologyInfectious DiseasePlastic SurgeryOB-GYNCardiologyPM&R (Physical Medicine & Rehab)General SurgeryCardiothoracic SurgeryEndocrinologyPulmonologyCode 95700Code 95705Code 95708Code 95717Code 95719Code 95721Code 95723Code 95725Code 90912Code 90913Code J80Code J96.01Code U07.1Code U07.2Code E1800Code E1802Code E1805Code E1810Code E1812Code 20560Code 20561

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