CommercialReimbursementMedium impact
Reimbursement Policies
EmblemHealth·Cardiology, Radiology·Provider News
Effective date
Sep 26, 2025
We identified it
Jun 20, 2026
Summary
EmblemHealth has updated radiology cardiology ultrasound reimbursement policies administered by EviCore, affecting bundling rules, correct coding rules, and frequency rules. Additionally, 9 coding edits originally scheduled for July 4, 2025 have been delayed and will now begin September 26, 2025.
Action Required
Before September 26, 2025: Billing team must review updated EmblemHealth radiology cardiology ultrasound policies on the EmblemHealth website for specific bundling, correct coding, and frequency rules administered by EviCore. Update billing system rules and staff training materials to reflect the delayed implementation of 9 coding edits. Monitor revision histories for exact effective dates of each policy component.