CommercialBilling CodesMedium impact
25-1111sum Summary Update: 3rd Quarter 2025 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA · Oncology, Rheumatology, Endocrinology +5 more·Pharmacy
Effective date
Jan 8, 2026
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) Crosswalk for Q3 2025, adding 18 new injectable medications, 9 new biosimilars, 3 new generic drugs, and 45 updates to existing procedure codes. The billing team must obtain and review the complete crosswalk document to ensure proper coding and billing responsibility allocation.
Action Required
Before January 8, 2026: Billing team must download the complete 25-1111 Injectable Medication HCPCS/DOFR Crosswalk (PDF) from the Health Net Provider Library to identify all 75 code changes and updates. Update billing system with new HCPCS codes for injectable medications and verify Division of Financial Responsibility categories match the Provider Participation Agreement. Review biosimilar and generic drug additions to ensure proper coding.