Medicare AdvantagePrior AuthHigh impact
Preauthorization Lists Revised With CMS’ Quarterly Updates for January 2023
EmblemHealth·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare have updated their preauthorization lists to align with CMS quarterly updates for January 2023. Billing teams should use the Preauthorization Check Tool in provider portals to verify which codes now require prior authorization, as the lists have changed.
Action Required
Immediately: Billing team must check all procedures against the updated preauthorization lists using the Preauthorization Check Tool in EmblemHealth and ConnectiCare provider portals before scheduling services. Update billing system flags for any newly added codes requiring prior authorization. Verify preauth requirements for all pending cases to avoid claim denials.