CMS Interoperability Reporting

The following files provide Healthfirst’s 2025 prior authorization metrics for our plans as well as a list of codes that currently require prior authorization across our lines of business, in accordance with the CMS Interoperability and Prior Authorization final rule.

ON THIS PAGE ON THIS PAGE
Medicare plans Medicaid plans Medicaid Advantage Plus Child Health Plus Prior authorization code list

Medicare plans

Medicaid plans

  • Medicaid Managed Care
  • Health and Recovery Plan (HARP)

Medicaid Advantage Plus

  • Medicaid Only Services for Medicaid Advantage Plus

Child Health Plus

  • Child Health Plus

Prior authorization code list

  • Healthfirst Prior Authorization Code List

You are now navigating away from the Healthfirst website.

Links to non-Healthfirst websites are provided for your convenience only. Healthfirst is not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.