24-786sum Summary Update: 2nd Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk
Date: 08/02/24
Use the updates for dates of service on and after October 7, 2024
On April 9, 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. P&T Committee members include physicians and representatives from participating physician groups (PPGs).
The approved updates, effective October 7, 2024, are listed on pages 2-4 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:
- 12 new injectable medications to be added to the DOFR crosswalk.
- 11 updates and changes to injectable medication procedure codes.
- 6 updated categories.
- 3 updates for new generic drugs.
To obtain a comprehensive description of the above topics, the complete update,
24-786, New: 2nd Quarter 2024 Injectable Medication HCPCS/DOFR Crosswalk (PDF), will be available on the
provider portal in the Provider Library.
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.