All PlansPrior AuthHigh impact
Important Prior Authorization Notifications for January 2026
Healthfirst·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Important prior authorization notifications are effective for January 2026, with updates, removals, and new requirements on select billing codes. Specific details require accessing the full policy document to determine exact code changes and requirements.
Action Required
By December 31, 2025: Billing team must access the full policy document at https://hfproviders.org/whatsnew/important-prior-authorization-notifications-effective-january-2026 to identify specific codes with updated prior authorization requirements. Update billing software and encounter forms with new prior auth rules for affected codes. Train staff on changes to prevent claim denials starting January 1, 2026.