MedicaidCoverageMedium impact
Nebulizer Coverage for Medicaid and HARP Members
EmblemHealth·NY · Pulmonology, Family Medicine, Internal Medicine +2 more·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth now covers nebulizer compressors, accessories, and associated medications as covered benefits for Medicaid and HARP members. Coverage is split between EmblemHealth directly and through NYRx pharmacy or DMEPOS providers depending on the specific item.
Action Required
Immediately: Billing team should visit the EmblemHealth provider hub to review the coverage guidelines and determine which nebulizer items are covered by EmblemHealth versus NYRx pharmacy or DMEPOS providers. Update billing procedures to route claims to the appropriate payer based on item type for Medicaid and HARP members.