Sexually Transmitted Infections (STIs)

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

Diagnosis and treatment of sexually transmitted infections (STIs) are available to Health Net Medi-Cal members without prior authorization under Health Net's contract with the Department of Health Care Services (DHCS). Members may choose any qualified provider, in- or out-of-network, including local health departments (LHDs) and family planning clinics, for care of an STI episode without prior authorization. STI services include education, prevention, screening, counseling, diagnosis, and treatment.

Out-of-network services provided by LHDs and family planning providers are limited to the following:

  • One visit for STIs that are amenable to immediate diagnosis and treatment including: bacterial vaginosis, trichomoniasis, candidiasis, herpes simplex, human papillomavirus, gonorrhea, non-gonococcal urethritis, and Chlamydia
  • One initial visit for primary or secondary syphilis and up to five additional visits for clinical and serological follow-up and treatment
  • A maximum of three visits for diagnosis and treatment of chancroid, lymphogranuloma venereum, granuloma inguinale, and pelvic inflammatory disease (PID)

Additional visits require prior authorization and may require that the member be referred back to his or her primary care physician (PCP) for any additional medically necessary follow-up or treatment.

For community providers other than LHD and family planning providers, out-of-network services are limited to one office visit per disease episode (follow-up care must be obtained by an in-network provider).