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Education Events & Patient Care Resources - Video - 2025
Provider Education Events - Recorded Video Sessions

Browse our previously recorded webinars and training sessions.

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Provider Events
  
Documentation & Coding - Video - 2025
Video - Risk Adjustment 101

This video focuses on Risk Adjustment 101.

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Clinical Documentation Improvement
Video
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2025
Update on NYS Medicaid Coverage for Therapeutic Transcranial Magnetic Stimulation (TMS)

Effective November 1, 2025, Healthfirst will provide coverage for Therapeutic Transcranial Magnetic Stimulation (TMS) for eligible Medicaid, Medicaid Advantage Plus (MAP), and Health and Recovery Plan (HARP) members diagnosed with Treatment-Resistant Major Depressive Disorder (MDD)..

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Administration
Healthfirst Plans
Medicaid
Reimbursement
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-156 Non-Covered Codes – Medicaid Managed Care and Child Health Plus

This policy outlines the reimbursement guidelines for non-covered CPT® and HCPCS codes billed to Healthfirst for Medicaid Managed Care and Child Health Plus.

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Reimbursement Policy
  
Provider Alerts - Pharmacy Resources & Formularies - Practice Guidelines and Tips - 2025
Obtaining Physician-Administered Drugs through a Specialty Pharmacy

As a Healthfirst provider, you can get Physician-Administered Drugs (PADs) delivered to your office at no cost through White Bagging when the medication is obtained from a Healthfirst in-network specialty pharmacy provider.

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Pharmacy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-151 Preventative Service Codes with Medicare Status Indicator "N"

This policy outlines Healthfirst’s reimbursement methodology for preventive service codes 9938199387, 99391–99397, 99401–99404, and 99411–99412.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-114 Medical Nutrition Therapy and Counseling

This policy outlines the reimbursement guidelines for Medical Nutrition Therapy and Counseling. Healthfirst will reimburse covered Medical Nutrition Therapy and Counseling services provided by licensed professionals.

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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.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-155 Non-Covered Codes – Medicare

This policy outlines the reimbursement approach for non-covered Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes submitted by providers participating in Healthfirst Medicare Advantage (MA) plans.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-153 Hospital Outpatient Clinic Visit – CPT/HCPCS Code G0463

This policy outlines the billing, coding, and reimbursement guidelines for hospital clinic visits billed under HCPCS code G0463.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-102 Taxonomy

A taxonomy code is a unique 10-character alphanumeric code that signifies a provider’s classification and area of specialization.

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Reimbursement Policy
  
Provider Alerts - Policy, Billing, or Coverage Update - 2025
Prior Authorization Guidelines for Select Services Effective February 1, 2026

Starting February 1, 2026, Healthfirst will add prior authorization requirements for selected vision services. These changes are part of Healthfirst’s ongoing responsibility to evaluate its medical policies compared to the latest scientific evidence and specialty society guidance.

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Authorization
  
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