MedicaidBilling CodesMedium impact
24-1057sum Summary Update: 3rd Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA·Pharmacy
Effective date
Dec 6, 2024
We identified it
Jun 20, 2026
Summary
Health Net's Pharmacy Advisory Committee approved updates to the Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) Crosswalk effective December 6, 2024. The update includes 22 new injectable medications, 14 procedure code changes, 1 category update, and 8 new generic drug updates that will affect billing responsibilities between providers and the health plan.
Action Required
Before December 6, 2024: Billing team must access the complete update 24-1057 from the Health Net provider portal under Provider Library > Updates and Letters > 2024 to review the specific 22 new injectable medications, 14 procedure code changes, and updated DOFR categories. Update billing system and encounter forms to reflect new financial responsibility assignments for injectable medications. Contact CalViva Health at 888-893-1569 with questions.