All PlansAdministrativeMedium impact
Make Summer Plans for Child Wellness Visits, Including Dental
EmblemHealth·Pediatrics, Family Medicine, General Practice·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth encourages scheduling child wellness visits during summer, emphasizing the connection between oral and overall health. Billing teams should use appropriate claim modifiers for separate services when combining well-child visits with other appointments, and use GT modifier for telehealth well-child visits.
Action Required
Immediately: Billing team should ensure claim modifier for separate and distinct services is added when well-care visits are conducted alongside illness visits or other services. For telehealth well-child visits, verify appropriate CPT codes are submitted with GT modifier. Update encounter forms to remind providers about opportunity to schedule wellness visits during sick visits.