CommercialBilling CodesHigh impact
Reimbursement Policies
EmblemHealth·Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Provider News
Effective date
Sep 13, 2024
We identified it
Jun 20, 2026
Summary
EmblemHealth is implementing a new policy requiring specific modifiers for all habilitative and rehabilitative services claims starting September 13, 2024. Claims submitted without the appropriate modifiers will be automatically rejected for incorrect coding.
Action Required
By September 13, 2024: Billing team must update system to require appropriate modifiers for all habilitative and rehabilitative services claims submitted to EmblemHealth and ConnectiCare. Review the full policy to identify which specific modifiers are required for each service type. Update encounter forms and EMR templates to prompt providers for modifier selection. Failure to append proper modifiers will result in automatic claim rejections.