MedicaidBilling CodesMedium impact
20-173 New Updates to the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 1st Quarter 2020
Health Net·CA · Oncology, Hematology, Ophthalmology +4 more·Prior Authorization
Effective date
May 4, 2020
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk Reference Table adding 12 new injectable medications, updating 3 procedure codes, and changing 14 existing medications to include Home Health/Infusion as a secondary category. This affects billing and coverage determination for injectable medications in Medi-Cal programs.
Action Required
Before May 4, 2020: Billing team must update their Injectable Medication HCPCS/DOFR Crosswalk Reference Table with the new drug codes and category assignments. Update billing system to reflect new HCPCS codes for 12 new injectable medications and updated codes for 3 existing medications. Verify proper DOFR category assignments for all affected injectable medications, particularly those now eligible for Home Health/Infusion billing.