CommercialCoverageMedium impact
Revised Medical Policy
EmblemHealth·Provider News
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
ConnectiCare updated their Experimental, Investigational or Unproven Services Policy effective January 1, 2023, adding new codes and removing others from their list of non-covered experimental procedures. This affects which services will be considered investigational and potentially denied coverage.
Action Required
Immediately: Billing team must obtain the updated ConnectiCare policy document JP 61384 02/2023 to identify specific codes added or removed from experimental status. Review current claims for ConnectiCare members to ensure services are not coded with newly designated experimental procedures. Update billing system notes to flag potential experimental services for ConnectiCare prior to submission.