CommercialReimbursementMedium impact
Reimbursement Policy Updates
EmblemHealth·Ophthalmology·Provider News
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare have introduced a new formal Ophthalmology Services Reimbursement Policy and updated Commercial Preventive Services grids. Additionally, new coding edits for modifier JW (drug amount discarded/not administered) are now included in reimbursement policies effective January 1, 2023.
Action Required
Immediately: Billing team must review and implement the new Ophthalmology Services Reimbursement Policy for EmblemHealth and ConnectiCare patients. Update billing system to include modifier JW coding edits for drug wastage documentation. Review updated Commercial Preventive Services grids and modify encounter forms accordingly. Check Revision History document for specific effective dates of each change.