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Provider Updates for September 2026
Healthfirst·Effective Sep 1, 2026
Healthfirst updated its reimbursement policy for E/M services billed with preventive medicine visits, effective September 1, 2026. E/M services (CPT 99202-99215) billed with Modifier 25 on the same date as preventive services will now be reimbursed at 50% of the contracted allowable amount instead of full payment. The policy also introduces new coverage for complexity add-on code G2211 for Medicaid members ages 0-20 years in pediatric primary care, reimbursable once per week per patient.