Back to dashboard
MedicaidDocumentationMedium impact

20-115 Refer to Updated PCS Form to Authorize Transport for Patients

Health Net·CA·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

Health Net requires immediate use of an updated Physician Certification Statement (PCS) form to document medical necessity for non-medical transportation (NMT) and non-emergency medical transportation (NEMT) for Medi-Cal members. The form must specify physical and medical limitations that prevent patients from using public or private transportation.

Action Required

Action needed
Immediately: Download the updated PCS form from Health Net's Provider Library and begin using it for all Medi-Cal transportation requests. Providers (MD, RN, NP, PCP, LVN, PA, or discharge planners) must document specific physical and medical limitations that prevent patients from using public transportation. Access the form at provider.healthnet.com > Working with Health Net > Contractual > Policy Library > Operations Manuals > Benefits > Transportation > PCS Form.

Related policy hubs