MedicaidReimbursementMedium impact
20-221 Prop 56 Payments for Family Planning
Health Net·CA · OB-GYN, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Health Net Medi-Cal is providing supplemental Prop 56 payments for family planning services including contraceptives, sterilization procedures, and pregnancy testing. Providers must submit updated W-9 forms and ensure clean claims are filed within one year of service to receive these additional payments on top of regular Medi-Cal rates.
Action Required
Immediately: Billing team must ensure W-9 forms are updated if not submitted in past 12 months by emailing HNCA_W9_Submissions@Centene.com with 'Prop 56 W9' in subject line. Include current address, TIN, and NPI. File clean claims with qualifying family planning CPT codes within one year of service date. Exclude CPT codes 11976, 11981, 58300, 58301, 55250, 58340, 58555, 58565, 58600, 58615, 58661, 58670, 58671, 58700 when billed with modifier UA or UB as they are not eligible for supplemental payments.