MedicaidBilling CodesHigh impact
26-334sum Summary Update: 1st Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA·Pharmacy
Effective date
May 15, 2026
We identified it
Jun 20, 2026
Summary
Health Net/CalViva Health updated their Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) Crosswalk effective May 15, 2026, adding 11 new injectable medications, updating 98 existing procedure codes, adding 8 new biosimilars, and 13 new generic drugs. This affects how injectable medications are categorized for billing and financial responsibility determination.
Action Required
Before May 15, 2026: Billing team must access the complete update 26-334 from the Provider Library (Medi-Cal section) to review all 130 code changes and updates. Update billing software with new HCPCS codes for 11 new injectable medications, 8 biosimilars, and 13 generic drugs. Review and implement changes to 98 existing injectable medication procedure codes. Update DOFR categories in billing system to match new crosswalk requirements.