24-1058sum Summary Update: 3rd Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk
Date: 10/01/24
Use the updates for dates of service on and after December 6, 2024
The Health Net Pharmacy Advisory Committee approved updates to the Injectable Medication Healthcare Common Procedure Coding System (HCPCS)/Division of Financial Responsibility (DOFR) Crosswalk. The Pharmacy Advisory Committee members include physicians and pharmacists.
The approved updates, effective December 6, 2024, are listed on pages 2-5 of the complete update. Injectable medications are placed in DOFR categories that mirror the DOFR matrix categories in the Health Net and Community Health Plan of Imperial Valley Provider Participation Agreement (PPA).
The update includes:
- 22 new injectable medications to be added to the DOFR crosswalk.
- 14 updates and changes to injectable medication procedure codes.
- 1 updated category.
- 8 updates for new generic drugs.
To obtain a comprehensive description of the above topics, the complete update,
24-1058, New: 3rd Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk, will be available on the
provider portal in the Provider Library under Updates and Letters > 2024; search for provider update 24-1058. Providers who do not have access to the internet may request a print copy of update 24-1058 by contacting the Provider Communications Department by email.
Additional information
Relevant sections of the provider operations manual will be revised to reflect the information contained in this update as applicable.
If you have questions regarding the information contained in this update, contact Community Health Plan of Imperial Valley at 833-236-4141.
This information applies to Participating Physician Groups (PPGs).
This information applies to Medi-Cal in Imperial county.