MedicaidBilling CodesMedium impact
26-017sum Summary Update: 4th Quarter 2025 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA·Pharmacy
Effective date
Mar 10, 2026
We identified it
Jun 20, 2026
Summary
CalViva Health updated their Injectable Medication HCPCS/Division of Financial Responsibility Crosswalk for 4th Quarter 2025, adding 21 new injectable medications, 21 procedure code updates, 8 new biosimilars, 7 new generic drugs, and 3 category changes. These updates affect how injectable medications are categorized for billing and financial responsibility determination.
Action Required
Before March 10, 2026: Billing team must download and review the complete update 26-017 from the Provider Library at healthnetcalifornia.com to identify specific injectable medication HCPCS codes affected by the 21 new medications, 21 code updates, 8 biosimilars, 7 generics, and 3 category changes. Update billing system with new codes and category assignments for proper Division of Financial Responsibility determination. Contact CalViva Health at 888-893-1569 with questions.