Reimbursement Policies

09/15/2025

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.

  • Coding Edits Reimbursement Policies (9 of the edits originally scheduled to start July 4, 2025, will begin to be applied Sept. 26, 2025.) 
  • EmblemHealth: Radiology Cardiology Ultrasound Bundling Rules (Administered by EviCore) Reimbursement Policy 
  • EmblemHealth: Radiology Cardiology Ultrasound Correct Coding Rules (Administered by EviCore) Reimbursement Policy 
  • EmblemHealth: Radiology Cardiology Ultrasound Frequency Rules (Administered by EviCore) Reimbursement Policy

 

 

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