Compliance, Regulatory & Policies

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

This policy outlines Healthfirst's reimbursement methodology for Evaluation and Management (E&M) services and additional office and outpatient services billed on the same date of service.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-109 Vaccine Administration

This policy establishes Healthfirst's reimbursement guidelines for vaccine administration services.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Colorectal cancer (CRC) is the term used to describe the development of cancer in the colon or the rectum.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-067 Evaluation of Dry Eyes

Dry eye disease (dysfunctional tear syndrome, DED) is defined by the Dry Eye Workshop II as “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-066 Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Abuse of both prescription and illicit drugs is extremely common.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-060 Biomarker Testing for Autoimmune Rheumatic Disease

Systemic autoimmune rheumatic diseases (SARDs) are a diverse group of conditions that primarily affect the joints, bones, muscle, and connective tissue.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-059 Allergen Testing

Allergic disease is characterized by inappropriate or exaggerated rated immune reactions to foreign antigens (allergens) that are generally innocuous to most people, but when introduced into a genetically-predisposed individual, elicit a hypersensitivity reaction.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-055 Pancreatic Enzyme Testing for Acute Pancreatitis

Pancreatitis is an inflammation of pancreatic tissue and can be either acute or chronic.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-052 Helicobacter pylori Testing

Helicobacter pylori (H. pylori) is a spiral-shaped, gram-negative bacteria that thrives while living in acidic environments, growing in close association with the stomach lining.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-050 Hepatitis Testing

Infectious hepatitis is an inflammation of the liver caused by the hepatitis viruses.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-041 Serum Tumor Markers for Malignancies

Circulating tumor biomarkers are substances detected in the blood, urine, or other body fluids that are either produced by a tumor itself or in response to its presence.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-037 Urinary Tumor Markers for Bladder Cancer

Bladder cancer is defined as a malignancy that develops from the tissues of the bladder. It is the most common cancer of the urinary system.

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Reimbursement Policy

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Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

Reimbursement Policy: PO-RE-109 Vaccine Administration

Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Reimbursement Policy: PO-RE-067 Evaluation of Dry Eyes

Reimbursement Policy: PO-RE-066 Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Reimbursement Policy: PO-RE-060 Biomarker Testing for Autoimmune Rheumatic Disease

Reimbursement Policy: PO-RE-059 Allergen Testing

Reimbursement Policy: PO-RE-055 Pancreatic Enzyme Testing for Acute Pancreatitis

Reimbursement Policy: PO-RE-052 Helicobacter pylori Testing

Reimbursement Policy: PO-RE-050 Hepatitis Testing

Reimbursement Policy: PO-RE-041 Serum Tumor Markers for Malignancies

Reimbursement Policy: PO-RE-037 Urinary Tumor Markers for Bladder Cancer

Resource Type

Filter

Year

Sort By

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

Reimbursement Policy: PO-RE-109 Vaccine Administration

Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Reimbursement Policy: PO-RE-067 Evaluation of Dry Eyes

Reimbursement Policy: PO-RE-066 Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Reimbursement Policy: PO-RE-060 Biomarker Testing for Autoimmune Rheumatic Disease

Reimbursement Policy: PO-RE-059 Allergen Testing

Reimbursement Policy: PO-RE-055 Pancreatic Enzyme Testing for Acute Pancreatitis

Reimbursement Policy: PO-RE-052 Helicobacter pylori Testing

Reimbursement Policy: PO-RE-050 Hepatitis Testing

Reimbursement Policy: PO-RE-041 Serum Tumor Markers for Malignancies

Reimbursement Policy: PO-RE-037 Urinary Tumor Markers for Bladder Cancer

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