Provider News
Reimbursement Update for High-Cost Clinician-Administered Drugs (HCCADs)
Effective June 2, 2025, there will be a change in reimbursement for the following High-CostClinician-Administered Drugs (HCCAD): HCCADsProcedure...
The NCQA Awards Health Outcomes and Community-Focused Care Accreditations for Health Equity Efforts and Community Care
Community First Health Plans has earned the prestigious National Committee for Quality Assurance (NCQA) Health Outcomes and Community-Focused Care Accreditations for our Medicaid and Commercial health plans. It is our honor to join a small but committed group of...
Summer 2026 Provider Newsletter Now Available!
The Community First Summer 2026 Provider Newsletter is now available. This issue features important updates, compliance guidance, Provider Portal enhancements, care coordination resources, quality initiatives, and clinical tools designed to support your practice and...
Community First Health Plans and Vheda Health Launch Outcomes-First Virtual Maternity Program in Texas
Community First Health Plans, Inc. (Community First) is partnering with Vheda Health, the leader in outcomes and analytics through virtual health engagement, to support high-risk mothers living with diabetes and hypertension across Texas. The program is designed to...
Implant Billing and Reimbursement Guidelines for Inpatient and Outpatient Services
Community First Health Plans is providing guidance on billing and reimbursement requirements for implantable devices for both inpatient and outpatient hospital services. Proper coding and documentation are required to ensure accurate claims processing and to avoid...
Wheeled Mobility Systems: QRP Seating Assessment and Billing Guidance
Community First Health Plans is providing guidance on billing requirements for services performed by a Qualified Rehabilitation Provider (QRP) related to wheeled mobility system and wheelchair seating assessments and fittings. Proper adherence to these billing...

