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Provider Alerts - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2022
COVID-19 Coding Update for CPT 99072

Healthfirst aims to ensure that our reimbursement policy standards are up to date and compliant with state and national industry standards. Effective immediately, Healthfirst will not reimburse for CPT code 99072.

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COVID-19
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2021
0370 21 Reimbursement Policy Updates for 6121 v5

As a part of Healthfirst’s continuing efforts to ensure that our reimbursement policy standards are up to date and compliant with state and national industry standards, effective June 1, 2021, several changes will be made to our reimbursement policy. These changes will maintain compliance with industry-accepted coding and reimbursement practices, as well as state and national regulatory requirements. Policy updates for: Polysomnography and Sleep Studies, Unattended Polysomnography and Sleep Studies, and Home Polysomnography and Sleep Studies.

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Reimbursement
  
Education Events & Patient Care Resources - Quality Program Resources - Coronavirus (COVID-19) - General Update - 2021
Bringing Patients Back to Get the Care They Need

Getting care in a timely manner leads to better health outcomes. Outreach your patients/Healthfirst members directly to schedule appointments and prioritize patients who are overdue for a visit or screening/exam.

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Patient Resource
  
Provider Alerts - Behavioral Health and Foster Care - Policy, Billing, or Coverage Update - 2021
Delayed: Applied Behavioral Analysis (ABA) Benefit Carve Out

The October 1, 2021 Applied Behavioral Analysis (ABA) benefit carve out into Managed Medicaid has officially been postponed by New York State Department of Health. Providers should continue to submit claims for ABA services to Medicaid Fee-For-Service directly until further notice.

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Medicaid
  
Provider Alerts - Quality Program Resources - General Update - 2022
Celebrating Top Performers from the 2020 Healthfirst Quality Incentive Program (HQIP)

Thank you to all our providers for your hard work in the Healthfirst Quality Incentive Program. We would like to recognize the top performers from the 2020 HQIP for achieving the highest overall quality ratings among their peers.

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HQIP
  
Provider Alerts - Claims & Billing - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2021
Coronavirus: Type (COVID-19) — Cost-Sharing Waiver

Please be advised that the New York State Department of Financial Services, the New York State Department of Health, and the federal government have directed Healthfirst to waive patient copayments, coinsurance, and deductibles for certain testing and treatment due to the coronavirus (COVID-19) emergency.

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COVID-19
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2021
Healthfirst Reimbursement Policy Updates Effective September 1, 2021

Healthfirst aims to ensure that our reimbursement policy standards are up to date and are compliant with state and national industry standards. Effective September 1, 2021, several changes will be made to our reimbursement policy to maintain compliance with industry-accepted coding and reimbursement practices as well as state and national regulatory requirements.

Open document
Reimbursement
  
Claims & Billing - Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2021
Reimbursement Policy: Anesthesia Start and Stop Times

Healthfirst requires that providers include the start time, stop time, and duration of anesthesia in the note segment of the 5010 claim form.

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Reimbursement
  
Behavioral Health and Foster Care - Form - 2020
Adult Behavioral Health (BH) and Community Based Services (HCBS): Initial Service Notification Following Level of Service (LOS) Determination
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Personal Wellness Plan
  
Behavioral Health and Foster Care - Practice Guidelines and Tips - 2020
Frequently Asked Questions: Authorizations for Inpatient Treatment of Substance Use Disorders
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Substance Use Disorder
  
Provider Alerts - Policy, Billing, or Coverage Update - 2020
Authorization Requirement Update for Echocardiography Services
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Authorization
  
Behavioral Health and Foster Care - Practice Guidelines and Tips - 2020
NYS Children’s Medicaid – Children and Family Treatment and Support Services
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Children & Family
  
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