CommercialCoverageMedium impact
REVISED: Benefit Updates for City of New York Members
EmblemHealth·NY·Provider News
Effective date
Oct 1, 2022
We identified it
Jun 20, 2026
Summary
City of New York GHI CBP Plan members now have updated copay structures effective October 1, 2022 for Montefiore providers and ProHEALTH Urgent Care, plus new radiology copays at non-preferred facilities starting November 1, 2022. High-tech radiology at most New York facilities now requires $100 copay instead of $50.
Action Required
Immediately: Update billing system and front desk staff to collect correct copays for City of New York GHI CBP members - $15 for Montefiore PCPs, $30 for Montefiore specialists, $100 for ProHEALTH Urgent Care, $50 for other urgent care, and $100 for high-tech radiology (CT, MRI, MRA, PET, Nuclear Medicine, 3DI) at non-RadNet/non-MSKCC/non-HSS facilities in NY State. Verify patient eligibility and facility network status before services.