26-1061sum Summary Update: 3rd Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk
Date: 09/11/26
Use the updates for dates of service on and after November 17, 2026
The Pharmacy Advisory Committee approved updates to the Injectable Medication HCPCS/Division of Financial Responsibility (DOFR) Crosswalk. The Pharmacy Advisory Committee members include physicians and pharmacists.
The approved updates, effective November 17, 2026, are included in the complete update. Injectable medications are placed in DOFR categories that mirror the DOFR matrix categories in the Health Net and CalViva Health Provider Participation Agreement (PPA).
The update includes:
- 11 new injectable medications to be added to the crosswalk
- 27 updates and changes to current injectable medication procedure codes
- 15 new biosimilars and updates to be added to the crosswalk
- 6 new generic medications
- 3 corrections on DOFR categorization to current injectable medication procedure codes
- 2 administrative changes to current injectable medication procedure codes
- 21 code description updates to current injectable medication procedure codes
Access the complete update for detailed information
For a comprehensive description of the above topics, the complete update, 26-1061, 3rd Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk (PDF), is available in the Provider Library > Medi-Cal > Provider Updates and Notices > search for 26-1061. Providers who do not have access to the internet may request a print copy of the update by emailing Provider Communications.
This information applies to Participating Physician Groups (PPGs).
This information applies to Medi-Cal in Fresno, Kings and Madera counties.