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What's New

Important New Posted Jan 30, 2025
Reminder Regarding Diabetic Testing Supplies

Ascenia/Bayer (Contour and Contour Next) products

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Important New Posted Jan 28, 2025
New Prior Authorization Requirements for CPT Codes Effective April 2025

Starting April 6, 2025, Healthfirst will add prior authorization requirements for selected medical services.

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New Posted Jan 22, 2025
EyeMed to Manage Prior Authorization for Six New Codes Starting April 2025

EyeMed manages Healthfirst’s prior authorization for surgical and therapeutic vision services as well as network management, related member and provider service calls, and claims payment for routine vision and medical optometry services.

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Posted Jan 14, 2025
Pediatric Vaccine Counseling Now Covered for Medicaid and Child Health Plus Members

As part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program, Healthfirst will reimburse providers for pediatric vaccine counseling visits for Medicaid and Child Health Plus members under 21 years of age.

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Posted Jan 13, 2025
Provider Education Events

Check out our calendar and sign up for an event today.

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Posted Jan 10, 2025
See the latest news about Availity Essentials™

Providers can access Healthfirst tools through Availity Essentials, our new secure provider portal platform.

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Posted Jan 07, 2025
Prior Authorization Guidelines for Select CPT and HCPCS Codes Effective March 2025

Starting March 20, 2025, Healthfirst will add prior authorization requirements for selected medical 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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Posted Jan 02, 2025
Scheduling Configuration Changes for Linked and Mutual Visits

Starting January 1, 2025, Healthfirst is creating new service codes to accurately account for Linked and Mutual Visits provided to Medicaid, Personal Wellness Plans (HARP), Senior Health Partner (SHP) and CompleteCare (CC) members.

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Posted Jan 01, 2025
Important Plan and Coverage Changes for 2025

As part of the Inflation Reduction Act, changes are being instituted to help make healthcare more affordable. These changes go into effect on January 1, 2025, and could affect many of your patients.

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Posted Dec 31, 2024
Changes to the Healthfirst Connection Plan (HMO D-SNP) and Life Improvement Plans Beginning in 2025

Starting January 1, 2025, Providers will need to bill Medicaid Fee-for-Service or Member’s Medicaid Coverage for Healthfirst Connection Plan Members’ cost sharing.

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Posted Nov 29, 2024
Diabetes Cost-Sharing Reduction for Essential Plan, Leaf Plan, and Leaf Premier Plan Members

Starting January 1, 2025, New York State of Health is implementing a Diabetes Cost-Sharing Reduction initiative to make services more accessible and affordable. Learn more about these cost-sharing reductions in this Provider Alert...

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Posted Nov 25, 2024
Changes to Claims Submissions for Prenatal and Postpartum Services

To understand the timing and delivery of perinatal services, the New York State Department of Health is requiring changes to claims submissions for perinatal services for Medicaid, Personal Wellness Plans (HARP), Medicaid Advantage Plans, and Connection Plan lines of business.

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