MedicaidBilling CodesMedium impact
25-1113sum Summary Update: 3rd Quarter 2025 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA·Pharmacy
Effective date
Jan 8, 2026
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk for Q3 2025, adding 18 new injectable medications, 9 biosimilars, 3 generics, and making 45 code updates with 4 category changes. This affects how injectable medications are coded and processed for reimbursement.
Action Required
Before January 8, 2026: Billing team must download the complete update document (25-1113) from the Provider Library to review all 18 new injectable medications, 9 biosimilar updates, 3 new generics, and 45 procedure code changes. Update billing system with new HCPCS codes and DOFR category assignments. Contact Community Health Plan at 833-236-4141 with questions.