MedicaidBilling CodesMedium impact
25-337sum Summary Update: 1st Quarter 2025 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 20, 2026
Summary
Health Net has 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 new generic drugs. This affects how injectable medications are categorized and billed under provider participation agreements.
Action Required
Before June 16, 2025: Billing team must download the complete update document (25-337) from the Health Net Provider Library and review pages 2-7 for specific HCPCS code changes. Update billing system with new injectable medication codes and DOFR category assignments. Contact CalViva Health at 888-893-1569 with questions about specific codes or categories.