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MedicaidBilling CodesMedium impact

24-785sum Summary Update: 2nd Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk

Health Net·CA·Pharmacy
Effective date
Oct 7, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk effective October 7, 2024, adding 12 new injectable medications, updating 11 procedure codes, and revising 6 categories for billing division of financial responsibility. This affects how injectable medications are categorized and billed for Medi-Cal patients in specific California counties.

Action Required

Action needed
By October 7, 2024: Billing team must download and review the complete update 24-785 from the Health Net provider portal library to identify specific HCPCS code changes for injectable medications. Update billing system with new DOFR categories for the 12 new injectable medications and 11 updated procedure codes. Contact CalViva Health at 888-893-1569 with questions about implementation.