Back to dashboard
MedicaidBilling CodesMedium impact

21-798 Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 4th Quarter 2021

Health Net·CA · Oncology, Neurology, Endocrinology +3 more·Prior Authorization
Effective date
Jan 28, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Health Net updated their Injectable Medication HCPCS/DOFR crosswalk with 15 new injectable medications and 35 code updates/changes for Medi-Cal patients in Fresno, Kings, and Madera counties. The changes include new codes for drugs like Aduhelm, Empaveli, and various flu vaccines, plus removal of obsolete codes and replacement of temporary codes with permanent ones.

Action Required

Action needed
By January 28, 2022: Billing team must update system with new injectable medication HCPCS codes including C9399/J3590 for Aduhelm, J3490 for Empaveli and Wegovy, new flu vaccine codes 90662/90686/90687/90688, and remove obsolete codes like Q2035, Q0239, and various discontinued flu vaccine codes. Update encounter forms and billing software to reflect code replacements (e.g., J0741 replaces J3490 for Cabenuva, J1448 replaces J3490 for Cosela). Applies only to Medi-Cal patients in Fresno, Kings, and Madera counties.

Affected Billing Codes

C9399
J3590
J3490
J9318
J9319
90662
90686
90687
90688
J2182
90656
Q2035
A9590
Q0239
Q2054
J0741
J1448
J9100
J9110
J1305
J0699
J0693
90653
90673
Q2036
90672
Q2037
90658
90630
Q2038
Q2039
90655
J7326
J9247