All PlansPrior AuthMedium impact
Prior Authorization No Longer Required for Select Codes Starting April 1, 2026
Healthfirst·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Starting April 1, 2026, prior authorization will no longer be required for select billing codes, streamlining the approval process for certain procedures. This change will reduce administrative burden and potentially speed up patient care for affected services.
Action Required
By March 15, 2026: Billing team must update billing software to remove prior authorization requirements for the specified codes listed in the full policy. Update encounter forms and provider workflows to reflect that these services no longer require pre-approval. Review internal authorization tracking systems to ensure they align with the new requirements.