Posted Apr 08, 2026
Effective May 1, 2026, Healthfirst is updating reimbursement policies for genetic and molecular lab testing for all Healthfirst Plans with respect to our new partnership with Concert Genetics.
A printable PDF is available here.
Healthfirst has partnered with Concert Genetics, a laboratory benefits manager that aims to improve payment accuracy for genetic and molecular testing.
Effective May 1, 2026, Healthfirst is updating reimbursement policies for genetic and molecular lab testing for all Healthfirst Plans with respect to our new partnership with Concert Genetics. Providers will need to bill for genetic and molecular testing services according to the coding recommendations in the Concert portal. These updates will align with industry standards, including the American Medical Association (AMA).
Concert Genetics is a healthcare technology company enabling cost-effective access to diagnostics and therapeutics by harmonizing evidence, care, and payment.
Healthfirst has partnered with Concert Genetics to provide data and technology to support the organization’s relationship with genetic testing laboratories that provide testing services to plan members. This work involves improving the clarity of linkages between the specific tests offered by laboratories and the billing codes associated with those tests.
The reimbursement policy applies to codes billed from the following sections in the CPT/HCPCS Manual:
Providers may also view Healthfirst’s Diagnostic Laboratory Reimbursement Policy for a full outline of Healthfirst’s standards and requirements, including genetic and molecular testing requirements.
Existing providers should register with Concert Genetics before May 1, 2026.
To register, providers may go to concertgenetics.com/join-healthfirst and submit a registration request.
Within two business days, providers will receive a welcome packet via email from Concert with an invitation to the Concert Genetics Platform, where providers can review and validate the accuracy of their test catalog data and complete the quality questionnaire.
Why register for Concert Genetics?
Concert Genetics is free to Healthfirst providers and offers the following benefits:
Will training and customer support be offered to labs affected by the policy?
Concert Genetics will provide training materials and other documentation to assist labs with registration. In addition, Concert Genetics will provide online, email, and phone support during and after registration.
Who should labs contact for questions about registration?
Providers can contact Concert customer support by email at help@concert.co or by phone at (615) 861-2634 or toll free (855) 435-7643.
If you have any questions, please contact your Network Account Manager, or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am-5:30pm.
Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”).
Released April 2026
