All PlansPrior AuthMedium impact
Prior Authorization Required for Select Codes Starting June 1, 2026
Healthfirst·Prior Authorization
Effective date
Jun 1, 2026
We identified it
Jun 20, 2026
Summary
A new policy requires prior authorization for select medical billing codes starting June 1, 2026. The billing team needs to prepare their systems and workflows to obtain prior authorization for the specified codes before that date.
Action Required
By May 31, 2026: Billing team must identify which specific codes will require prior authorization once the full policy details are available. Update billing software to flag these codes for prior auth requirements. Train staff on new prior authorization workflows. Notify providers about codes requiring prior auth to prevent claim denials.