23-1320sum Summary Update: New: 4th Quarter 2023 Injectable Medication HCPCS/DOFR Crosswalk

Date: 12/01/23

Use the updates for dates of service on and after February 7, 2024

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, effective February 7, 2024, are listed on pages 3-4 of the complete update. Injectable medications are placed in DOFR categories that mirror the DOFR matrix categories in the Health Net Provider Participation Agreement (PPA).

The update includes:

• 16 new injectable medications to be added to the DOFR crosswalk.
• 16 updates and changes to injectable medication procedure codes.
• 2 updates for new generic drugs.

The complete update, 23-1320, New: 4th Quarter 2023 Injectable Medication HCPCS/DOFR Crosswalk (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 23-1320 by contacting the Health Net Provider Communications Department by email.

Additional information

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.
 

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.