CommercialBilling CodesMedium impact
20-171 New Updates to the Injectable Medication HCPCS/DOFR Crosswalk Reference Table - 1st Quarter 2020
Health Net·CA · Oncology, Hematology, Ophthalmology +2 more·Pharmacy
Effective date
May 4, 2020
We identified it
Jun 20, 2026
Summary
Health Net updated their Injectable Medication HCPCS/DOFR Crosswalk Reference Table effective May 4, 2020, adding 12 new injectable medications with specific HCPCS codes, updating 3 existing procedure codes, and changing DOFR categories for 14 medications. This affects billing and coverage determination for injectable medications across participating physician groups in specific California counties and Medi-Cal programs.
Action Required
By May 4, 2020: Billing team must update billing systems and crosswalk reference tables with the new HCPCS codes for 12 injectable medications, update 3 changed procedure codes (J9199 for Infugem, J0642 for Khapzory, C9055 for Zulresso), and modify DOFR categories for 14 medications that now include Home Health/Infusion as secondary category. Download updated Injectable Medication HCPCS/DOFR Crosswalk Reference Table from Health Net Provider Library and train staff on proper code assignment for injectable medications.