Reimbursement Policies

The following reimbursement policies have been updated. If the policy name does not have a company name shown, the policy applies to both EmblemHealth and ConnectiCare. Refer to the website applicable to the member’s plan (EmblemHealth | ConnectiCare) and see the revision histories for effective dates and applicable changes. 

• Evaluation and Management (E&M) Services.
• Coding Edits Policy.
• Discontinued Procedures – Modifiers 53, 73 & 74 (Commercial). 
• EmblemHealth Preventive Care Services (Commercial).
• EmblemHealth Preventive Care Services (Medicare).
• ConnectiCare Preventive Care Services (Commercial and Medicare).

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