HF Logo HF Logo
Provider Home / Compliance, Regulatory & Policies
Resource Type
Clear All
Filter
Year
Sort By
Showing 1-12 of 142
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-074 Remote Patient Monitoring and Remote Therapeutic Monitoring

The purpose of this policy is to outline the reimbursement guidelines for Remote Patient Monitoring (RPM) services and Remote Therapeutic Monitoring (RTM) services offered by Healthfirst.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-078 Telemedicine

This policy outlines the guidelines for telemedicine and telehealth services eligible for reimbursement by Healthfirst.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-106 e-Consult Visits

This document describes the eConsult visit policy Healthfirst Utilization Management follows when reimbursing for services provided by contracted providers.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-095 Anesthesia Services

Healthfirst Anesthesia policy is developed in part using the Centers for Medicare and Medicaid Services (CMS) National Correct Coding Initiative (NCCI) Policy Manual, CMS NCCI edits and the CMS Regional Physician Fee Schedule, American Society of Anesthesiologists guidelines, and its own medical policies regarding the coding of claims.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-127 Canalith Repositioning Procedure

Healthfirst adheres to the Centers for Medicare & Medicaid Services (CMS) guidelines for Canalith Repositioning Procedures. This policy outlines the reimbursement criteria and procedure for the CPT code 95992, which is designated for the therapeutic management of benign paroxysmal positional vertigo (BPPV).

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-131 Psychological and Neuropsychological Testing

Effective May 1, 2025, Healthfirst will implement a new reimbursement policy for Psychological-Neuropsychological testing. This policy is aligned with Local Coverage Determination L34520 and Local Coverage Article A57780 R-10-01-2024 (Jurisdiction N).

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-001 Vitamin D Testing

Vitamin D is a precursor to steroid hormones and plays a key role in calcium absorption and mineral metabolism.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-005 Diagnostic Testing of Iron Homeostasis & Metabolism

Iron, an essential nutrient with a variety of biological uses, is tightly regulated in vivo to maintain homeostasis.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-006 Vitamin B12 and Methylmalonic Acid Testing

Vitamin B12, also known as cobalamin, is a water-soluble vitamin required for proper red blood cell formation, key metabolic processes, neurological function, and DNA regulation and synthesis.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-012 Pathogen Panel Testing

Infectious diseases can be caused by a wide range of pathogens. Conventional diagnostic methods like culture, microscopy with or without stains and immunofluorescence, and immunoassay often lack sensitivity and specificity and have long turnaround times.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-023 Diabetes Mellitus Testing

Diabetes describes several heterogeneous diseases in which various genetic and environmental factors can result in the progressive loss of β-cell mass and/or function that manifests clinically as hyperglycemia (Skyler et al., 2017).

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-029 Testosterone Testing

Testosterone is a naturally occurring lipophilic androgen hormone that is produced by both males and females for various functions.

Open document
Reimbursement Policy
  
You are now navigating away from the Healthfirst website.

Links to non-Healthfirst websites are provided for your convenience only. Healthfirst is not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.