The updated ABA policy outlines applicable requirements, including coverage criteria, authorization requirements, documentation expectations, and other relevant guidance for ABA services.
View postTo ensure Healthfirst members receive quality, consistent, and timely care, a provider questionnaire has been introduced to accompany the initial prior authorization request for Adult Physical Therapy.
View postTake a mid-year moment to refresh your documentation and coding knowledge.
View postPlease review these lab policies to understand how they may impact claims submission and payment.
View postCodes newly released by the American Medical Association will include prior authorization requirements starting July 1, 2026.
View postEffective October 1, 2026, Healthfirst will require prior authorization for select medical services.
View postLearn more about key updates providers should know.
View postProviders are encouraged to review these updated policies to ensure compliance with current billing and reimbursement requirements.
View postThe Medicare GLP-1 Bridge is a short-term demonstration run by CMS that will provide eligible Medicare Part D beneficiaries with access to certain GLP-1 drugs beginning July 1, 2026 through December 31, 2027.
View postHealthfirst updated its Obstetric Billing Guidelines reimbursement policy to incorporate updated national coding standards and New York State (NYS) Medicaid billing guidance for maternity care.
View postIn alignment with New York State (NYS) Medicaid guidelines, provider eligibility and claim reimbursement for breast cancer surgical procedures must be performed at approved (contracted) facilities.
View postHealthfirst updated its reimbursement policy for dental services covered under the medical benefit when medically necessary to a covered medical condition or procedure.
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