23-1006sum Summary Update: Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table- 3rd Quarter 2023
Date: 09/08/23
Use the updates for dates of service on and after November 14, 2023
On July 11, 2023, the Health Net Pharmacy and Therapeutics (P&T) Committee approved updates to the Injectable Medication Healthcare Common Procedure Coding System (HCPCS)/Division of Financial Responsibility (DOFR) Crosswalk.
The approved updates are effective November 14, 2023. Injectable medications are placed in DOFR categories that mirror the DOFR matrix categories in the Health Net Provider Participation Agreement (PPA).
The update includes:
- 17 new injectable medications to be added to the DOFR crosswalk.
- 26 updates and changes to injectable medication procedure codes.
- 20 updates for new generic drugs.
The complete update, 23-1006, Stay Current with the Injectable Medication HCPCS/DOFR Crosswalk Reference Table – 3rd Quarter 2023 (PDF), is a comprehensive description of the above topic. Providers who do not have access to the internet may request a print copy of update 23-1003 by contacting the Provider Communications Department by email.
Additional information
Relevant sections of the provider operations manuals have been revised to reflect the information contained in this update as applicable. Provider operations manuals are available electronically in the Provider Library on the provider portal > Quick Links.
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email by telephone or through the Health Net provider portal.
Line of business | Phone number | Email address |
|---|---|---|
IFP Ambetter PPO | 844-463-8188 | |
IFP Ambetter HMO | 888-926-2164 | |
Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 800-641-7761 | |
Medicare (Individual & Employer Group) | 800-929-9224 | |
Medi-Cal | 800-675-6110 | N/A |
This information applies to Participating Physician Groups (PPGs).
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.