CommercialBilling CodesHigh impact
26-773 IONM Billing Requirements Change, Effective August 14, 2026
Health Net·CA · Neurosurgery, Orthopedics, Cardiothoracic Surgery +2 more·Reimbursement
Effective date
Aug 14, 2026
We identified it
Jun 20, 2026
Summary
Health Net is implementing new IONM billing requirements effective August 14, 2026, that align with CMS guidelines. Only specific CMS-recognized codes will be reimbursed, with strict unit limits and monitoring requirements that must be met to avoid claim denials.
Action Required
Before August 14, 2026: Billing team must update system to only allow CPT 95940 and HCPCS G0453 for covered IONM services, block CPT 95941 as non-covered. Configure edits to limit billing to maximum 4 units per 60-minute period and ensure total units don't exceed monitoring time. Verify Place of Service codes POS 19, 21, 22, or 24 are used. Prevent surgeons and anesthesia providers from billing these codes separately. Claims not meeting these requirements will be denied.