Medicare AdvantageAdministrativeHigh impact
New Reimbursement Policies
EmblemHealth·Provider News
Effective date
May 16, 2023
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare are implementing three new policies: Part D vaccines cannot be billed under Part B in physician offices (effective May 16, 2023), all services from the same provider on the same date must be filed on a single claim to prevent split billing (effective June 4, 2023), and HCPCS/CPT coding requirements have been reformatted into a new template with no policy changes.
Action Required
By May 16, 2023: Stop billing Part D vaccines under Part B medical benefit for EmblemHealth patients (already applies to ConnectiCare). By June 4, 2023: Billing team must consolidate all services from same provider on same date into single claims for both EmblemHealth and ConnectiCare. Update billing software to prevent split billing. Claims found to be split billed will be subject to audits, denials, and recoveries.