What's New

Behavioral Health Benefit Carve-in to Medicaid Advantage Plus Plans

Effective January 1, 2023, New York State is carving additional Behavioral Health services into the Medicaid Advantage Plus plan.

Personalized Recovery Oriented Services (PROS) Update

Effective Nov. 21, 2022, Healthfirst, in accordance with the State of New York, will no longer require prior authorization for Personalized Recovery Oriented Services (PROS).

Reminder: Prior Authorization for Genetic and Molecular Laboratory Services

eviCore providing authorization services for Genetic and Molecular laboratory services.

Reminder regarding members who seek mental health or substance abuse services

Child HCBS Authorizations and Reminder of State Billing and Claiming Requirements

This notice is to remind Children’s Home and Community-Based Services (HCBS) providers of HCBS billing and claiming requirements, per the April 4, 2022, NYSDOH memo.

Community Oriented Recovery and Empowerment (CORE) Services

Four Behavioral Health Home and Community Based Services transitioning to a new service array called CORE Services

Telehealth Resources Available

For best practices, coding and billing tip sheets, and more

Delayed: Applied Behavioral Analysis Benefit Carve Out

Learn more about the delay and what that means for you

Billing Guidance for Dual-Eligible Special Needs Plan (D-SNP) Members Under Healthfirst’s Plans

Stay current on billing practices

Children and Family Treatment and Support Services (CFTSS)

Learn more about CFTSS

Bringing Patients Back to Get the Care They Need

Access these helpful tips and resources