All PlansBilling CodesHigh impact
20-647 New Updates to the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 3rd Quarter 2020
Health Net·CA · Oncology, Hematology, Rheumatology +3 more·Prior Authorization
Effective date
Nov 3, 2020
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk Reference Table effective November 3, 2020, adding 12 new injectable medications with specific HCPCS codes, updating 18 existing medication procedure codes, and changing 1 DOFR category assignment. This affects billing and prior authorization requirements for injectable medications administered by participating physician groups.
Action Required
Before November 3, 2020: Billing team must update billing software and encounter forms with 12 new injectable medication HCPCS codes (C9059, J3490, Q5121, A9590, J7204, A9513, J1201, C9399, J9999, J7333, J0691) and 18 updated codes with new descriptions. Update DOFR category assignments for proper division of financial responsibility. Access updated provider operations manuals in the Health Net Provider Library for complete crosswalk reference table. Contact Health Net Provider Services within 60 days with questions.