25-1203 Respite Services Made Easier: New Authorization Guide and Form Streamline Support for Caregivers
Date: 11/20/25
Simplified referral and authorization process launches
December 1, 2025
Effective December 1, 2025, Health Net, on behalf of CalViva Health, is updating its Respite Services Authorization Guide and Authorization Form to make it easier for providers to request caregiver support services. These updates aim to improve clarity, streamline the referral process, and ensure timely relief for caregivers.
What’s changing?
- Prior authorization not required for HCPCS code S9125 – As a reminder, HCPCS code S9125 no longer requires prior authorization as of December 1, 2025. This was previously communicated in provider update 25-996 Streamlining Prior Authorization: Simplifying Process for Better Efficiency, distributed on September 24, 2025.
- Service definition updates – the Department of Health Care Services has made minor changes to service definitions to help clarify the purpose and scope of respite services. These do not impact eligibility or service offerings.
Access the updated documents
The revised Respite Services Authorization Guide and Authorization Form will be available on December 1, 2025, on the CalAIM resources page > Community Supports > Forms & Tools.
Additional information
Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569. Behavioral Health providers can call at 844-966-0298.
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, Enhanced Care Management (ECM) Providers, and Behavioral Health Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.