25-843sum Summary Update: Updates to the Prior Authorization Requirements
Date: 08/27/25
Stay informed on the latest changes to codes, medications and other services and procedures effective now and in the coming months
Refer to the complete update, 25-843, Updates to the Prior Authorization Requirements (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 that require prior authorization as of July 1, 2025.
- Additions, effective immediately and on November 1, 2025.
- Changes, effective immediately.
How to access prior authorization requirements
Access the Medi-Cal Los Angeles County Department of Human Services (LA-DHS) Participating Physician Groups Prior Authorization List at Prior Authorizations.
Additional information
Relevant sections of Health Net’s provider operations manuals have been revised to reflect the information contained in this update as applicable. Provider operations manuals are available electronically in the Provider Library on Health Net’s provider portal.
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) County.