CommercialPrior AuthMedium impact
Preauthorization Updates – Quarterly Code Updates
EmblemHealth·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare update their preauthorization lists quarterly based on new CPT and HCPCS codes from AMA and CMS. Claims containing new codes will be partially processed, with the new codes held for configuration until loaded into the system within 60 days.
Action Required
Immediately: Review the updated preauthorization lists linked in the policy (EmblemHealth, GHI PPO City of New York, ConnectiCare Commercial, ConnectiCare Medicare, and Home Infusion Therapy Drug lists). Billing team should monitor for partial claim processing when using newly released CPT/HCPCS codes and expect reprocessing within 60 days once codes are configured in the system.