MedicaidAdministrativeMedium impact
26-873m Updates to Clinical Policies – June 2026
Health Net·CA·Provider News
Effective date
Jun 1, 2026
We identified it
Jul 18, 2026
Summary
Health Net California has released policy update 26-873m for June 2026 that includes clinical policy reviews and retirement of at least one policy. The specific changes, affected codes, and implementation requirements are detailed in a downloadable PDF provider update. This applies to physicians, practitioners, PPGs, hospitals, ancillary providers, and behavioral health providers across 11 California counties.
Action Required
By May 31, 2026: Download and review the Provider Update PDF from the Health Net California provider library (link: https://providerlibrary.healthnetcalifornia.com/news/26-873m-updates-to-clinical-policies---june-2026.html). Billing team must identify and document all specific policy changes, retired policies, and affected billing codes within the PDF. Update billing software, encounter templates, and prior authorization protocols based on the specific retired and updated policies. Providers in affected California counties (Amador, Calaveras, Inyo, Los Angeles, Molina, Mono, Sacramento, San Joaquin, Stanislaus, Tulare, Tuolumne) must be notified of changes by the June 2026 effective date. Failure to implement required changes may result in claim denials or payment adjustments.