CommercialReimbursementMedium impact
Updated Payment Reimbursement Policies
EmblemHealth·Reimbursement
Effective date
May 17, 2022
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare updated three reimbursement policies: added diagnosis codes for bone mass measurement to align with CMS guidelines, included new COVID-19 vaccine code 0074A effective May 17, 2022, and updated E&M services policy with same-day hospital care guidelines.
Action Required
Immediately: Billing team should review and update systems to incorporate new bone mass measurement diagnosis codes per CMS guidelines. Verify COVID-19 vaccine code 0074A is available in billing system (effective May 17, 2022). Update E&M billing procedures for same-day initial and subsequent hospital care encounters per new guidelines. Contact EmblemHealth/ConnectiCare for specific code lists and documentation requirements.