MedicaidAdministrativeMedium impact
School-Based Health Center Services
EmblemHealth·NY · Pediatrics, Family Medicine, General Practice·Provider News
We identified it
Jun 20, 2026
Summary
New York State has delayed the transition of school-based health center services from Medicaid Fee-For-Service to Medicaid Managed Care. EmblemHealth providers must continue billing school-based health center services to NY State Medicaid FFS instead of managed care until further notice.
Action Required
Immediately: Billing teams serving EmblemHealth Medicaid members in New York must continue submitting all school-based health center (SBHC and SBHC-D) service claims to New York State Medicaid Fee-For-Service system. Do not transition these claims to Medicaid Managed Care billing. Update billing protocols and staff training to reflect continued FFS processing until state provides further guidance.