MedicaidBilling CodesMedium impact
23-199sum Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 1st Quarter 2023
Health Net·CA·Pharmacy
Effective date
May 3, 2023
We identified it
Jun 20, 2026
Summary
CalViva Health has updated their Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) Crosswalk Reference Table for Q1 2023, adding 11 new injectable medications, updating 7 procedure codes, and adding 32 new generic drugs to determine billing responsibility between providers and the health plan.
Action Required
By May 3, 2023: Billing team must access the complete policy update 23-199 from the CalViva Health Provider Library to review the 11 new injectable medications, 7 updated procedure codes, and 32 new generic drugs. Update billing system and encounter forms to reflect new DOFR categories for injectable medications. Contact CalViva Health at 888-893-1569 with questions. Failure to use updated crosswalk may result in incorrect billing responsibility determination.