21-336m Prior Authorization Reminder for Outpatient Therapy Visits
Date: 05/10/21
This information applies to Physicians.
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Be sure to get prior authorization after 12 combined visits
Health Net’s fee-for-service (FFS) providers must request prior authorization for the below outpatient therapies/rehabilitation services after 12 combined visits.
- Physical therapy
- Occupational therapy
- Speech therapy
Visits 1-12 do not require authorization.
View PA requirements online
Access PA lists, request forms and validation tools with these steps:
1 Go to the provider website.
2 Pre-log in, select Working with Health Net. Under Additional Resources, select Services Requiring Prior Authorization.
Additional information
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email within 60 days, by phone or through the Health Net provider website as listed below.
Line of Business | Telephone Number | Provider Portal | Email Address |
|---|---|---|---|
EnhancedCare PPO (IFP) | 1-844-463-8188 |
| |
EnhancedCare PPO (SBG) | 1-844-463-8188 |
| |
Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 1-800-641-7761 |
| |
IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO) | 1-888-926-2164 |
| |
Medicare (individual) | 1-800-929-9224 |
| |
Medicare (employer group) | 1-800-929-9224 |
| |
Medi-Cal | 1-800-675-6110 |
| N/A |