Healthfirst for Providers

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Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Non-Pressure Ulcer

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for common types of Non-Pressure Ulcer.

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Clinical Documentation Improvement

Provider Alerts - Claims & Billing - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2021

COVID-19 Testing — Billing Guidance

Healthfirst will cover medically appropriate COVID-19 testing at no cost share during the public health emergency when such testing is ordered by a physician or licensed healthcare professional for the purpose of diagnosis or treatment of COVID-19.

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COVID-19

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

This policy outlines Healthfirst's reimbursement methodology for Evaluation and Management (E&M) services and additional office and outpatient services billed on the same date of service.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-109 Vaccine Administration

This policy establishes Healthfirst's reimbursement guidelines for vaccine administration services.

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Reimbursement Policy

Documentation & Coding - Practice Guidelines and Tips - 2026

Documentation and Coding: Stroke/CVA and Malignant Neoplasm

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for Stroke/CVA and Malignant Neoplasm

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Clinical Documentation Improvement

Provider Alerts - Policy, Billing, or Coverage Update - 2026

Physical and Occupational Therapy Authorization and Approval Guidance

New Occupational Therapy Requirements Effective June 29, 2026

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Administration

Authorization

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Colorectal cancer (CRC) is the term used to describe the development of cancer in the colon or the rectum.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-067 Evaluation of Dry Eyes

Dry eye disease (dysfunctional tear syndrome, DED) is defined by the Dry Eye Workshop II as “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-066 Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Abuse of both prescription and illicit drugs is extremely common.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-060 Biomarker Testing for Autoimmune Rheumatic Disease

Systemic autoimmune rheumatic diseases (SARDs) are a diverse group of conditions that primarily affect the joints, bones, muscle, and connective tissue.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-059 Allergen Testing

Allergic disease is characterized by inappropriate or exaggerated rated immune reactions to foreign antigens (allergens) that are generally innocuous to most people, but when introduced into a genetically-predisposed individual, elicit a hypersensitivity reaction.

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Reimbursement Policy

Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026

Reimbursement Policy: PO-RE-055 Pancreatic Enzyme Testing for Acute Pancreatitis

Pancreatitis is an inflammation of pancreatic tissue and can be either acute or chronic.

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Reimbursement Policy

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Documentation and Coding: Non-Pressure Ulcer

COVID-19 Testing — Billing Guidance

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

Reimbursement Policy: PO-RE-109 Vaccine Administration

Documentation and Coding: Stroke/CVA and Malignant Neoplasm

Physical and Occupational Therapy Authorization and Approval Guidance

Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Reimbursement Policy: PO-RE-067 Evaluation of Dry Eyes

Reimbursement Policy: PO-RE-066 Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Reimbursement Policy: PO-RE-060 Biomarker Testing for Autoimmune Rheumatic Disease

Reimbursement Policy: PO-RE-059 Allergen Testing

Reimbursement Policy: PO-RE-055 Pancreatic Enzyme Testing for Acute Pancreatitis

Search

Resource Type

Filter

Year

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Documentation and Coding: Non-Pressure Ulcer

COVID-19 Testing — Billing Guidance

Reimbursement Policy: PO-RE-170 Additional Office and Outpatient Services Billed with Evaluation and Management (E&M)

Reimbursement Policy: PO-RE-109 Vaccine Administration

Documentation and Coding: Stroke/CVA and Malignant Neoplasm

Physical and Occupational Therapy Authorization and Approval Guidance

Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Reimbursement Policy: PO-RE-067 Evaluation of Dry Eyes

Reimbursement Policy: PO-RE-066 Prescription Medication and Illicit Drug Testing in the Outpatient Setting

Reimbursement Policy: PO-RE-060 Biomarker Testing for Autoimmune Rheumatic Disease

Reimbursement Policy: PO-RE-059 Allergen Testing

Reimbursement Policy: PO-RE-055 Pancreatic Enzyme Testing for Acute Pancreatitis

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