CommercialBilling CodesMedium impact
Reimbursement Policy Updates
EmblemHealth·Provider News
Effective date
Mar 1, 2023
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare formalized their Bundled Services Reimbursement Policy with no changes to current claim payments, but new codes will be added March 1, 2023. Multiple reimbursement policies were updated including home health, laboratory, preventive services, and ambulatory surgical grouper policies with specific payment rules for revenue codes 360 and 490.
Action Required
By March 1, 2023: Billing team must review the revision histories for all updated policies to identify new bundled service codes and preventive care list changes. Update billing system with new codes for EmblemHealth and ConnectiCare plans. For ambulatory surgical procedures, ensure revenue codes 360 or 490 are used to receive surgical contracted rates, otherwise claims will be paid at lower rates unless specifically negotiated.