Reimbursement Policies Posted October 1, 2026

Healthfirst has updated the below reimbursement policies in October 2026

Fertility and Preservation Services → See Reimbursement Policy

• Outlines Healthfirst’s reimbursement requirements for infertility and fertility preservation services across applicable lines of business

Additional Office and Outpatient Services Billed with Evaluation and Management (E&M) → See Reimbursement Policy

• Update contains the inclusion of Medicare lines of business, clarification of guidelines for childhood vaccine counseling, and modified policy language to clarify reimbursement guidelines

Routine and Non-Routine Foot Care → See Reimbursement Policy

• Establishes reimbursement requirements for covered podiatry services, including billing, coding, documentation, frequency limits, and coverage criteria

CCBHC Provider Billing Guidance – QHP (UB-04 Billing) → See Reimbursement Policy

• Outlines Healthfirst’s reimbursement requirements for Certified Community Behavioral Health Clinic (CCBHC) services provided to eligible Qualified Health Plan (QHP) members