MedicaidReimbursementMedium impact
Billing Guidelines Update for 29-I VFCAs
EmblemHealth·NY·Reimbursement
Effective date
Nov 20, 2025
We identified it
Jun 20, 2026
Summary
New York State removed the Non-Billable Services Chart for Article 29-I VFCAs, allowing practitioners to bill for all medically necessary services within their scope. Starting November 20, 2025, EmblemHealth claims must include all procedure codes for office visits, but non-billable codes will pay $0.
Action Required
By November 20, 2025: Billing team must update procedures for Article 29-I VFCA office visit claims to EmblemHealth to include ALL procedure codes delivered in the encounter. Review the updated NYSDOH billing manual to identify which codes are billable vs non-billable. Non-billable codes will be processed as one unit and pay $0. Contact medicaid_care_coordination_@emblemhealth.com with questions.