26-334sum Summary Update: 1st Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk
Date: 03/13/26
Use the updates for dates of service on and after May 15, 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 May 15, 2026, are listed on pages 2-8 of 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
- 98 updates and changes to current injectable medication procedure codes
- 8 new biosimilars and updates to be added to the crosswalk
- 13 new generic drugs
Access the complete update for detailed information
For a comprehensive description of the above topics, the complete update, 26-334, 1st Quarter 2026 Injectable Medication HCPCS/DOFR Crosswalk (PDF), is available in the Provider Library > select Medi-Cal > Provider Updates and Notices > search for 26-334. Providers who do not have access to the internet may request a print copy of the update by emailing Provider Communications.
Need help? Contact us
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
This information applies to Participating Physician Groups (PPGs).
This information applies to Medi-Cal in Fresno, Kings and Madera counties.