CommercialPrior AuthMedium impact
Preauthorization Updates – Quarterly Code Updates
EmblemHealth·Prior Authorization
Effective date
Feb 1, 2025
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare release quarterly updates to their preauthorization lists based on AMA and CMS code changes. Claims with new codes that haven't been configured yet will be partially processed, excluding the new codes until they're loaded into the system within 60 days.
Action Required
Immediately: Review the updated preauthorization lists on EmblemHealth's website for any codes relevant to your practice. Monitor claims with newly released CPT/HCPCS codes as they may be partially processed initially. Expect reprocessing of claims once new codes are configured within 60 days of their effective date.