MedicaidReimbursementMedium impact
PCMH Payments To Be Issued in April
EmblemHealth·NY · Family Medicine, General Practice, Internal Medicine +1 more·Provider News
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
EmblemHealth will issue Patient-Centered Medical Home (PCMH) payments in April 2025 for eligible primary care physicians based on NYS guidance. This includes retroactive payments for April-September 2024 services and adjusts the payment schedule to align with state fiscal year cycles.
Action Required
By April 2025: Primary care providers should verify their NCQA Patient-Centered Medical Home Recognition Program level status and confirm their Medicaid, HARP, and Child Health Plus patient panel sizes with EmblemHealth. Review the PCMH quick reference guide to understand payment calculations. Monitor for retroactive payment adjustments for services rendered April-September 2024.