Genetic and Molecular Test Coding Validation (Concert Genetics Partnership)
This policy governs reimbursement coding and billing processes for genetic and molecular laboratory testing for all Healthfirst plans following a partnership with Concert Genetics; it affects Healthfirst providers and laboratories that bill for these tests.
Healthfirst partnered with Concert Genetics and will require providers to bill genetic and molecular testing services according to coding recommendations in the Concert portal effective May 1, 2026.
Coding and Billing Coverage Criteria
Coding and billing criteria
Covered when ALL of the following are met:
ALL of the following
- Provider has registered with Concert Genetics before May 1, 2026 and completed the Concert registration process (providers receive a welcome packet within two business days after submitting a registration request).
- Genetic and molecular testing services are billed using CPT/HCPCS codes from the following sections: Molecular Pathology; Genomic Sequencing Procedures and Other Molecular Multianalyte Assays; Multianalyte Assays with Algorithmic Analyses; and Proprietary Laboratory Analyses (PLA) codes.
- Provider bills genetic and molecular testing services according to the coding recommendations published in the Concert Genetics portal (Healthfirst-aligned coding guidance effective May 1, 2026).
Operational note: to register, providers may go to https://www.concertgenetics.com/join-healthfirst/ and submit a registration request; welcome packet and platform invitation are sent within two business days.