All PlansPrior AuthMedium impact
Prior Authorization No Longer Required for Select Evicore Codes Starting April 2025
Healthfirst·Prior Authorization
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
Starting April 2025, prior authorization will no longer be required for select Evicore codes, streamlining the approval process for certain services. This change should reduce administrative burden and speed up patient care for affected procedures.
Action Required
Before April 1, 2025: Billing team must review the list of affected Evicore codes at the provided URL and update billing system workflows to remove prior authorization requirements for these specific codes. Update staff training materials and encounter forms to reflect that these codes no longer require prior authorization.