All PlansPrior AuthHigh impact
Prior Authorization Guidelines for Select CPT and HCPCS Codes Effective March 2025
Healthfirst·Prior Authorization
Effective date
Mar 1, 2025
We identified it
Jun 20, 2026
Summary
New prior authorization requirements are being implemented for select CPT and HCPCS codes effective March 2025. Healthcare practices will need to obtain prior authorization for specific procedures and services that previously did not require pre-approval.
Action Required
Before March 1, 2025: Billing team must access the full policy at https://hfproviders.org/whatsnew/prior-authorization-guidelines-for-select-cpt-and-hcpcs-codes-effective-march-2025 to obtain the complete list of affected CPT and HCPCS codes. Update billing system to flag these codes for prior authorization requirements. Train staff on new prior auth workflow for affected procedures. Failure to obtain prior authorization will result in claim denials.