CommercialReimbursementHigh impact
Reimbursement Policies
EmblemHealth·Provider News
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare have updated multiple reimbursement policies effective January 1, 2026, including new Nutritional Counseling Services coverage and revisions to DME rental, breast reconstruction, preventive care, and physician office procedures. Billing teams must review the updated policies on each payer's website to understand specific changes and requirements.
Action Required
Before January 1, 2026: Billing team must visit EmblemHealth and ConnectiCare websites to review updated reimbursement policies for DME rental vs purchase, free flap breast reconstruction, physician office procedures (formerly Modifier SU), preventive care services, and new nutritional counseling services. Update billing system rules, encounter forms, and staff training materials based on specific policy changes found in the revision histories.