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HealthfirstAll Plans · Coverage · Provider Update · Allergy & Immunology, Internal Medicine, PathologyMedium impact

Provider Updates for May 2026

Effective date
Jan 1, 2026
Identified
Jun 20, 2026

Summary

Healthfirst's Diagnosis of Idiopathic Environmental Intolerance policy (PO-RE-065v6) states that laboratory tests designed to confirm idiopathic environmental intolerance do not meet coverage criteria in all circumstances. For asymptomatic individuals and during general encounters without abnormal findings, screening and profiling tests for volatile solvents, organic acids, organophosphates, phthalates, parabens, chlorinated pesticides, carnitine, oxidative stress, vitamin, mineral, nutritional and metals testing also do not meet coverage criteria, and breath hydrogen and/or breath methane testing does not meet coverage criteria in any circumstances. The description for CPT codes 83015 and 83018 was revised effective 1/1/2026.

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What to do

Action · 4 steps
01Already effective 2026-01-01: The description for CPT codes 83015 and 83018 was revised.
02Billing team: do not submit claims for laboratory tests designed to confirm idiopathic environmental intolerance, since they do not meet coverage criteria in all circumstances.
03Billing team: for asymptomatic individuals and during general encounters without abnormal findings, do not submit claims for the blood, saliva, serum, plasma, urine or stool screening for volatile solvents, organic acids and organophosphates, the phthalate and paraben profiling, the chlorinated pesticide profiling, the carnitine, oxidative stress, antioxidant, detoxification, methylation, lipoic acid, CoQ10, intestinal hyperpermeability, vitamin, mineral or nutritional testing, or the metals testing, since these do not meet coverage criteria.
04Billing team: do not submit claims for breath hydrogen or breath methane testing (CPT 91065), since it does not meet coverage criteria under any circumstances.

Codes mentioned

8210882127821368213982300823798238082441824958250782525825428265382656827058271082715827268297883015830188315083497836558373583785838858391883919839218413484255844468458584590846008463086001863538912591065S3708

Original notice

Provider Updates for May 2026
hfproviders.org · Always check the source before changing claims.
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