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.
Provider Updates for September
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 allUpdate to Electronic Remittance Advice (ERA) Distribution Logic
This is part of an ongoing effort to improve the accuracy and consistency of Electronic Remittance Advice (ERA) delivery.
View postHow to Request a Continuous Glucose Monitoring Device
These devices must be obtained through an in-network Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) provider, rather than a pharmacy.
View postProstate Cancer Awareness Month (Sept 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 prostate cancer.
View postProvider Updates for September 2026
Learn more about key updates providers should know.
View postPrior Authorization Requirements for Select Codes Starting November 30, 2026
Effective November 30, 2026, Healthfirst will require prior authorization requirements for several CPT codes.
View postReminder: Non-Covered Codes for Medicaid Managed Care and Child Health Plus Reimbursement Policy Effective Feb. 1, 2026
Healthfirst is aligning with NYS Medicaid Billing Guidelines to ensure consistency in claims processing and reimbursement.
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