CommercialCoverageHigh impact
Oct. 1 Benefit Updates for City of New York Members
EmblemHealth·NY·Provider News
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
Effective October 1, City of New York GHI CBP Plan members will have new copay structures including standardized Montefiore copays ($15 PCP, $30 specialist), tiered urgent care copays ($50 preferred, $100 non-preferred with ProHEALTH now non-preferred), and tiered high-tech radiology copays ($50 preferred facilities, $100 non-preferred facilities).
Action Required
By October 1: Front desk staff must update patient registration system 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 visits, and $100 for high-tech radiology at non-preferred facilities (preferred facilities include RadNet, Memorial Sloan Kettering, Hospital for Special Surgery, ACPNY, and BronxDocs). Update billing system with new copay amounts and review Summary of Companies document when available October 1.