Reimbursement Policy Updates

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Reimbursement Policy Updates

10/14/2022

We are introducing a formal Ophthalmology Services Reimbursement Policy for EmblemHealth and ConnectiCare.

We have updated the Commercial Preventive Services grids (EmblemHealth|ConnectiCare). See the Revision History for applicable changes and their respective effective dates.

Effective Jan. 1, 2023, the Coding Edits reimbursement policies will include new edits applicable to modifier JW (drug amount discarded/not administered to any patient) (EmblemHealth|ConnectiCare).

Provider Update