Posted Mar 30, 2026
The following codes newly released by the Centers for Medicare and Medicaid Services (CMS) on April 1, 2026, will include prior authorization requirements starting June 1, 2026.
A printable PDF is available here.
The following codes newly released by the Centers for Medicare and Medicaid Services (CMS) on April 1, 2026, will include prior authorization requirements starting June 1, 2026. These changes are part of Healthfirst’s ongoing responsibility to evaluate its medical policies compared to the latest scientific evidence and specialty society guidance.
Meanwhile, prior-authorization requirements may be added/updated/removed for certain codes, and post-service determinations may still be applicable based on criteria published in medical policies or local/national coverage determination criteria.
Note: As of June 1, 2026 all new authorization requests will be reviewed under the updated guidelines. Please note that the addition /removal/ of prior authorization does not indicate coverage – plan benefit rules still apply.
| Code | Code Type | Description | Authorization Managed By |
|---|---|---|---|
| A4479 | HCPCS Level II | Electro pump enema, reusable | Integra |
| A8005 | HCPCS Level II | Grip glove w microprocessor | Integra |
| A8006 | HCPCS Level II | Grip glove replacement only | Integra |
| L2221 | HCPCS Level II | Ank mcrop plant & dorsi flex | Integra |
| A2045 | HCPCS Level II | Novashield or novogen wound matrix, per square centimeter | Integra |
| A2040 | HCPCS Level II | Microlyte painguard, per square centimeter | Integra |
| A2041 | HCPCS Level II | Foundation drs+ duo, per square centimeter | Integra |
| A2042 | HCPCS Level II | Foundation drs+ solo, per square centimeter | Integra |
| A2043 | HCPCS Level II | Biobrane, per square centimeter | Integra |
| A2044 | HCPCS Level II | Biobrane glove, each | Integra |
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.
April 2026
