25-525sum 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, 25-525, Prior Authorization Changes, Effective April 1, 2025, through August 1, 2025 (PDF), for prior authorization updates detailed below.

Key prior authorization requirement 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

Access the Medi-Cal Prior Authorization requirements at Prior Authorization and select the Medi-Cal Los Angeles County Department of Health Services (LA-DHS) Participating Physician Groups Prior Authorization List.

Additional information

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center at 800-675-6110. Behavioral health providers can call 844-966-0298.

 

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

For Medi-Cal, this information applies to Los Angeles (LA-DHS).