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MedicaidBilling CodesMedium impact

22-067 Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 1st Quarter 2022

Health Net·CA · Oncology, Family Medicine, Internal Medicine +2 more·Pharmacy
Effective date
Apr 18, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk for Medi-Cal providers in specific California counties, adding 11 new injectable medications and updating 16 existing medication codes. Several medications are no longer manufactured and their codes should be discontinued.

Action Required

Action needed
By April 18, 2022: Billing team must update billing system with 11 new injectable medication HCPCS codes and their corresponding DOFR categories. Replace 16 existing codes with updated versions (e.g., replace J3590 with Q2055 for Abecma, J2505 with J2506 for Neulasta). Discontinue billing for 6 medications no longer manufactured including Omontys, Protropin, and Vitrasert. Update encounter forms and medication lists to reflect these changes.

Affected Billing Codes

J1952
C9087
J3590
J2046
90677
J9021
C9086
Q0247
90671
J1445
J3490
Q2055
J0172
J1426
J2430
J9269
J9272
C9085
J2506
J0890
J2940
J9061
J2941
J3315
J7310
J2357
C9075
J9296
C9999
J2505
C9399