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New Guides for Quality Care

EmblemHealth·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

EmblemHealth is introducing two new resource guides to help billing staff correctly code claims for quality measure inclusion and exclusion: Transitions of Care guidance and Advanced Illness and Frailty Exclusions. Additional 2025 quality guides will be released soon.

Action Required

Action needed
Immediately: Billing team should access and review the new Transitions of Care and Advanced Illness and Frailty Exclusions resource guides from EmblemHealth. Update coding practices to ensure claims properly include qualifying patients and exclude non-qualifying patients from quality measures. Monitor for upcoming 2025 quality guide releases.

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