25-523sum Summary Update: Prior Authorization Changes, Effective April 1, 2025, through August 1, 2025

Date: 05/28/25

Learn what codes for medical benefit medications and other services have been added or removed

Refer to the complete update, 25-523, Updates to the Prior Authorization Process, and New and Upcoming Requirements Changes (PDF), for the prior authorization updates detailed below.

Key prior authorization requirements changes include:

• New CPT and HCPCS codes issued by the Centers for Medicare & Medicaid Services (CMS) that require prior authorization as of April 1, 2025.
• Additions and changes, effective immediately, on July 1 and on August 1, 2025.
• Removals, effective August 1, 2025.

How to access prior authorization requirements

Use either option below to access the Medi-Cal Prior Authorization Requirements:

• Go to the Provider Library, select Medi-Cal, then select Prior Authorization Requirements on the left side.
• Go to Prior Authorization and select the Imperial County – Community Health Plan of Imperial Valley (CHPIV) Prior Authorization List.

Additional information

If you have questions regarding the information contained in this update, contact Community Health Plan of Imperial Valley at 833-236-4141. Behavioral Health providers can call 844-966-0298.

 

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, and Behavioral Health Providers.

This information applies to Medi-Cal in Imperial county.