CommercialBilling CodesMedium impact
25-336sum Summary Update: 1st Quarter 2025 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA · Oncology, Rheumatology, Endocrinology +5 more·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) Crosswalk for Q1 2025, adding 16 new injectable medications, 40 procedure code updates, 15 new biosimilars, and 7 generic drug updates. The changes affect how injectable medications are categorized and billed under Health Net's provider participation agreement.
Action Required
By June 16, 2025: Billing team must download the complete update document (25-336) from Health Net's Provider Library to review all 78 injectable medication coding changes. Update billing system with new HCPCS codes for 16 new injectable medications, 15 biosimilars, and 7 generic drugs. Verify current injectable medication procedure codes against the 40 updates listed in the crosswalk to ensure proper DOFR category assignment and billing compliance.