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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-144 Advanced Primary Care Management (APCM) Services

This reimbursement policy outlines the guidelines and procedures for billing and reimbursement of Advanced Primary Care Management (APCM) services.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-141 Interprofessional Consultation for Behavioral Health Services

This reimbursement policy outlines the guidelines for billing and reimbursement of interprofessional consultations in behavioral health services as established by the Centers for Medicare & Medicaid Services (CMS) starting in 2025.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-103 Continuous Glucose Monitoring (CGM) - Billing Guidelines

Healthfirst provides reimbursement for Continuous Glucose Monitoring (CGM) devices for members diagnosed with diabetes, including Gestational diabetes, Type 1 and Type 2 diabetes.

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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

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Reimbursement Policy
  
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.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-019 Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus (HIV) is an RNA retrovirus that infects human immune cells, specifically CD4 cells, causing progressive deterioration of the immune system ultimately leading to acquired immune deficiency syndrome (AIDS) characterized by susceptibility to opportunistic infections and HIV-related cancers.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-007 Intracellular Micronutrient Analysis

Micronutrients are dietary components, often referred to as vitamins and minerals, which although only required by the body in small amounts, are vital to development, disease prevention, and wellbeing.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-004 Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing

Parathyroid hormone (PTH), along with calcitriol and fibroblast growth factor 23 (FGF23), regulate calcium and phosphate homeostasis.

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Reimbursement Policy
  
Education Events & Patient Care Resources - Provider Resources - 2025
Provider Education Events

See our calendar of provider education events and register today.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
Eighth Annual World Health Continuing Medical Education Conference, Panel 1

Health Disparities Impacting Global and Local Populations (June 6, 2025)

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
Eighth Annual World Health Continuing Medical Education Conference, Panel 2

Health Disparities Impacting Global and Local Populations (June 6, 2025)

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
Eighth Annual World Health Continuing Medical Education Conference, Panel 3

Health Disparities Impacting Global and Local Populations (June 6, 2025)

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Provider Events
  
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