Medicare AdvantagePrior AuthMedium impact
Provider Bulletin 09-30-2025 Q4 2025 Prior Authorization Look-Up Tool Update IM IE LA OC SAC SD
Molina Healthcare·CA · Wound Care, General Surgery, Orthopedics +1 more·Prior Authorization
Effective date
Sep 30, 2025
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California has updated their Prior Authorization Look-up Tool for Q4 2025, affecting healthcare administered drugs, hyperbaric/wound care, outpatient hospital/ASC procedures, and transplants/gene therapy. The PDF version of the PA Code Matrix is permanently discontinued, and providers must now use only the online look-up tool.
Action Required
Immediately: All billing staff must stop using PDF PA Code Matrix and transition to using only the Prior Authorization Look-up Tool at molinahealthcare.com for all Molina prior authorization requirements. Check the tool before every PA submission as codes may be added or removed quarterly. Update workflow to verify PA requirements online for healthcare administered drugs, hyperbaric/wound care, outpatient hospital/ASC procedures, and transplants/gene therapy.