Starting June 15, 2024, we are introducing a new EmblemHealth and ConnectiCare reimbursement policy for compression garments. EmblemHealth and ConnectiCare will follow CMS reimbursement guidelines for compression garments/stockings when prescribed by a physician and provided by a durable medical equipment (DME) supplier.
Please see revision histories for the updates to the following reimbursement policies:
- Anesthesia Billing.
- ConnectiCare Preventive Care Services (Commercial): Please note the update to ConnectiCare’s coverage requirements for behavioral health wellness exams as required by the Massachusetts Department of Insurance. See Behavioral Health Wellness Exams story in Commercial Updates section above.
- Evaluation and Management (E&M) Services: Please note, this policy has been updated to include Medicare coverage guidelines for G2211 starting Jan. 1, 2024.
- Hospital Readmissions.
Starting June 15, 2024, we will also introduce a new Lab Benefit Management (LBM) reimbursement policy, Testing of Homocysteine Metabolism for EmblemHealth and ConnectiCare in addition to updating the following LBM policies. See revision histories for applicable changes and effective dates.
- Coronavirus Testing in the Outpatient Setting (LBM).
- Diagnostic Testing of Iron Homeostasis & Metabolism (LBM).
- Immunohistochemistry (LBM).
- Serum Tumor Markers for Malignancies (LBM).
- Testosterone Testing (LBM).
- Vitamin B12 & Methylmalonic Acid Testing (LBM).
- Vitamin D Testing (LBM).
JP 64940 03/2024
