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.

Medicare Plans

Contract H3359
Contract H1722
Contract H5989
Contract H9678

Medicaid Plans

Medicaid Managed Care
Health and Recovery Plan (HARP)
MLTC

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