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MedicaidBilling CodesMedium impact

23-1319sum Summary Update: New: 4th Quarter 2023 Injectable Medication HCPCS/DOFR Crosswalk

Health Net·CA · Oncology, Rheumatology, Endocrinology +3 more·Pharmacy
Effective date
Feb 7, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net and CalViva Health updated their Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) crosswalk effective February 7, 2024. The update includes 16 new injectable medications, 16 procedure code updates, and 2 new generic drugs that affect billing and financial responsibility categories.

Action Required

Action needed
Before February 7, 2024: Billing team must download and review the complete update 23-1319 from the Health Net provider portal to identify specific HCPCS code changes for injectable medications. Update billing system with new DOFR categories and procedure codes. Contact CalViva Health at 888-893-1569 with questions. Claims may be processed incorrectly without updated crosswalk information.