CommercialBilling CodesHigh impact
New Habilitative and Rehabilitative Services Reimbursement Policy Begins Jan. 1, 2025
EmblemHealth·Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Provider News
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
EmblemHealth is implementing a new policy requiring specific modifiers on all habilitative and rehabilitative services claims starting January 1, 2025. Claims submitted without the appropriate modifiers will be automatically rejected for incorrect coding.
Action Required
By January 1, 2025: Billing team must update system to require appropriate modifiers on all habilitative and rehabilitative services claims for EmblemHealth. Review current habilitative/rehabilitative service billing to identify required modifier codes. Update billing software validation rules and staff training. Claims without proper modifiers will be rejected.