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MedicaidBilling CodesMedium impact

24-174sum Summary Update: 1st Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk

Health Net·CA·Pharmacy
Effective date
Apr 22, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health updated their Injectable Medication HCPCS/DOFR Crosswalk effective April 22, 2024, adding 20 new injectable medications, updating 17 procedure codes, and making 12 generic drug updates. This affects billing and coverage determination for injectable medications in Fresno, Kings, and Madera counties.

Action Required

Action needed
By April 22, 2024: Billing team must download the complete update 24-174 from the CalViva Health provider portal to review the 20 new injectable medications and 17 updated procedure codes. Update billing system with new HCPCS codes and DOFR categories. Contact CalViva Health at 888-893-1569 with questions. Review updated provider operations manual sections in the Provider Library.