Supporting Your Patients: Coverage Changes in 2026 and Beyond
Help members navigate their coverage options and maintain access to the care they need.
Review the latest updates, tools, and materials to support these conversations. (Updated 9/23/26)
Provider Updates for October
Stay ahead of important changes that may impact your practice
Review updates to prior authorization, reimbursement policies, provider manual changes, and more—all in one place.
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What's New
View allImportant Update: NPI and TIN Requirements for Claims Submission
Healthfirst is updating several internal systems and processes with the goal of modernizing provider data maintenance, claims processing, and benefits administration.
View postAccess to Care and Appointment Availability (ACAA) and Online Provider Directory (OPD) Provider Toolkit
Help your practice stay prepared and support members’ access to care.
View postReimbursement Policies Posted October 1, 2026
Providers are encouraged to review these policies to ensure compliance with current billing and reimbursement requirements.
View postNational Drug Code (NDC) Quantity and Qualifier Unit of Measure (UOM) Billing Guidance
In response to concerns raised by the provider community regarding the appropriate billing of National Drug Code (NDC) quantities and NDC qualifiers (Units of Measure or “UOMs”), Healthfirst is providing a waiver period for the applicable claim edits.
View postNational Breast Cancer Awareness Month (Oct 2026): Documentation and Coding Resources for Your Practice
The Healthfirst Clinical Documentation and Coding team offers resources to support accurate, complete documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for breast cancer.
View postProvider Updates for October 2026
Learn more about key updates providers should know.
View postReceive updates in your email
Provider Resources
Provider Alerts
Plans & Benefits
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