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Plan Now for Child Wellness Visits This Summer
EmblemHealth·Pediatrics, Family Medicine, General Practice·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth now allows telehealth for Well Child Visit compliance using appropriate CPT codes with GT modifier. Well-care visits can be conducted during illness visits as separate services with proper modifiers, and no referral is required for dental providers as part of comprehensive child wellness care.
Action Required
Immediately: Billing team must ensure Well Child Visit telehealth claims include GT modifier with appropriate CPT codes. When conducting well-care visits during illness appointments, add claim modifier for separate and distinct services. Update encounter forms to remind providers that no referral needed for dental provider recommendations during wellness visits.