Supporting Your Patients: Coverage Changes in 2026 and Beyond
Help members navigate their coverage options and maintain access to the care they need.
Review the latest updates, tools, and materials to support these conversations. (Updated 9/23/26)
Provider Updates for October
Stay ahead of important changes that may impact your practice
Review updates to prior authorization, reimbursement policies, provider manual changes, and more—all in one place.
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What's New
View allPrior Authorization Required for Select Services Starting October 1, 2026
CPT/HCPCS Level II codes newly released by the American Medical Association (AMA) and The Centers for Medicaid and Medicare Services - effective October 1, 2026 - will require prior authorization and will be managed by Healthfirst’s delegated vendor(s) EviCore, under the EviCore Lab Program and Integra.
View postPrior Authorization Requirements for Select Codes Starting December 30, 2026
Healthfirst will require prior authorization for select codes.
View postPublic Charge Regulation Update
In August 2026, USCIS updated Public Charge guidance, expanding case-by-case consideration of individual circumstances. Healthfirst encourages members to seek guidance before making changes to their or their children’s health coverage.
View postReimbursement Policies Posted October 1, 2026
Providers are encouraged to review these policies to ensure compliance with current billing and reimbursement requirements.
View postNational Breast Cancer Awareness Month (Oct 2026): Documentation and Coding Resources for Your Practice
The Healthfirst Clinical Documentation and Coding team offers resources to support accurate, complete documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for breast cancer.
View postProvider Updates for October 2026
Learn more about key updates providers should know.
View postProstate Cancer Awareness Month (Sept 2026): Documentation and Coding Resources for Your Practice
The Healthfirst Clinical Documentation and Coding team offers resources to support accurate, complete documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for prostate cancer.
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