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MedicaidCoverageLow impact

Homeless Healthcare Services

EmblemHealth·NY · Family Medicine, Internal Medicine, General Practice·Provider News
Effective date
Feb 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Starting February 1, 2025, EmblemHealth will reimburse licensed medical providers for primary care services delivered to homeless Medicaid and HARP members in shelters or on the street, regardless of whether the provider is the assigned PCP. Providers must be enrolled in NY State Medicaid, contracted with EmblemHealth, and associated with a physical office location.

Action Required

Action needed
By February 1, 2025: Billing team should verify that providers serving homeless populations are enrolled in NY State Medicaid program and properly contracted with EmblemHealth. Update billing procedures to ensure homeless healthcare services are billed at contracted PCP rates for eligible Medicaid and HARP members.