CommercialCoverageMedium impact
Encourage Members with Hypertension to Self-Monitor with Covered Device
EmblemHealth·Family Medicine, Internal Medicine, Cardiology +1 more·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth now covers automatic blood pressure monitors up to $40 with no cost-share or prior authorization for hypertension patients. Providers must use specific CPT II codes (3074F-3080F) to document digital blood pressure readings for HEDIS quality measure compliance.
Action Required
Immediately: Billing team must ensure CPT II codes 3074F-3080F are available in billing system for hypertension visits. Providers must document that blood pressure readings were taken with digital devices and submit appropriate CPT II codes based on systolic (<130, 130-139, ≥140) and diastolic (<80, 80-89, ≥90) readings. Update encounter forms to include these CPT II codes for EmblemHealth hypertension patients.