Policy Update for Commercial Dental Plan

10/02/2025

EmblemHealth is dedicated to providing high-quality dental coverage while adhering to state and federal requirements. We are also committed to enhancing the experience for both members and providers and keeping you informed of any changes to our plans.

The following change to our commercial dental plan – originally scheduled to take effect on March 7, 2025 – had been postponed. As we announced in March, a new date was forthcoming.

The new effective date for the following frequency change is Jan. 1, 2026.

  • Closure of an oroantral fistula or a sinus perforation (D7260- D7261) will change from no frequency limit to a frequency limitation of once every 12 months per quadrant.

Thank you for your continued partnership and the care you provide to our members.

JP 70123 10/25

Provider Update