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CommercialPrior AuthMedium impact

Preauthorization List Updates

EmblemHealth·OB-GYN, Radiology·Prior Authorization
Effective date
Apr 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth, ConnectiCare Commercial, and ConnectiCare Medicare have updated their preauthorization lists effective April 1, 2023, removing 149, 137, and 116 codes respectively. Additionally, CPT 76948 (ultrasonic guidance for ova aspiration) will be added to EmblemHealth's preauthorization list starting July 14, 2023.

Action Required

Action needed
By April 1, 2023: Billing team must review the specific 149 codes removed from EmblemHealth and 137/116 codes removed from ConnectiCare Commercial/Medicare preauthorization lists in the revision history. Update billing software to remove prior authorization requirements for these codes. By July 14, 2023: Add CPT 76948 to EmblemHealth's prior authorization requirements in billing system. Verify revision history documents for complete code lists.

Affected Billing Codes

76948