MedicaidBilling CodesMedium impact
25-020sum Summary Update: 4th Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA·Pharmacy
Effective date
Mar 18, 2025
We identified it
Jun 20, 2026
Summary
Health Net CalViva Health has updated their Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) Crosswalk with 23 new injectable medications, 11 procedure code updates, and 7 new generic drug updates. This affects how injectable medications are categorized and billed under the provider participation agreement.
Action Required
Before March 18, 2025: Billing team must download the complete update 25-020 from the Provider Library to review all 23 new injectable medications, 11 updated procedure codes, and 7 new generic drug updates. Update billing system rules and HCPCS code mappings according to the new DOFR crosswalk categories. Contact CalViva Health at 888-893-1569 with questions.