25-844sum Summary Update: Prior Authorization Requirement Changes, Effective July 1, 2025
Date: 08/27/25
Stay informed on new codes now in place
Refer to the complete update, 25-844, Prior Authorization Requirement Changes, Effective July 1, 2025 (PDF), for new CPT and HCPCS codes issued by the Centers for Medicare & Medicaid Services (CMS) that require prior authorization as of July 1, 2025.
How to access the Medicare Prior Authorization requirements:
- Go to the Provider Libraryviderlibrary > Medicare Advantage > Prior Authorization Requirements.
- Go to Prior Authorizations and select the Medicare - California Prior Authorization List.
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 by email, by telephone or through the Health Net provider portal.
Behavioral health providers can call 844-966-0298.
Provider Services
Line of business | Phone number |
Medicare (Individual & Employer Group) (Wellcare By Health Net) | |
Medicare Supplement |
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, and Behavioral Health Providers.