Medicare AdvantageCoverageMedium impact
Provider Updates for May 2026
Healthfirst·Family Medicine, Internal Medicine, Allergy & Immunology +1 more·Provider Update
Effective date
May 1, 2025
We identified it
Jun 20, 2026
Summary
Healthfirst has updated their coverage policy for Idiopathic Environmental Intolerance (IEI) testing, explicitly stating that laboratory tests to diagnose IEI and various screening tests for asymptomatic individuals do not meet coverage criteria. This policy restricts reimbursement for multiple types of chemical sensitivity, nutritional, and environmental exposure testing.
Action Required
By May 1, 2025: Billing team must review all claims for IEI-related testing and environmental sensitivity panels. Stop submitting claims to Healthfirst for laboratory tests designed to confirm IEI diagnosis, chemical exposure screening for asymptomatic patients, nutritional analysis panels, breath testing, and metal testing when performed for general encounters without abnormal findings. Update denial management procedures to expect denials for these services. Train providers on coverage restrictions for IEI testing.