CommercialCoverageHigh impact
20-709 Medical Policies - 2nd Quarter 2020
Health Net·CA · Pain Management, Gastroenterology, Pediatrics +10 more·Prior Authorization
We identified it
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.
Action Required
Immediately: Billing team must review all 24 updated policies on Health Net's provider portal under Medical Policies. Update prior authorization requirements for burn surgery and skin substitutes for chronic wounds. Verify coverage criteria for investigational procedures like radiofrequency ablation of uterine fibroids. Update 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). Remove trigger point injection codes 20560 and 20561 from coverage. Contact appropriate Health Net Provider Services Center within 60 days with questions or claims may be denied.