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CommercialPrior AuthMedium impact

Preauthorization Updates – Quarterly Code Updates

EmblemHealth·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth and ConnectiCare have updated their quarterly preauthorization lists based on new CPT and HCPCS codes from AMA and CMS. Claims containing new codes will be partially processed with the new codes held until configuration is complete within 60 days.

Action Required

Action needed
Immediately: Review the updated preauthorization lists for EmblemHealth and ConnectiCare at the provided links to identify which procedures now require prior authorization. Update billing workflows to check for prior auth requirements using the current lists. Monitor claims for partial payments on services with new CPT/HCPCS codes and follow up for reprocessing once codes are configured.

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