CommercialPrior AuthMedium impact
EmblemHealth Preauthorization List Update
EmblemHealth·Speech Therapy, Orthopedics·Prior Authorization
Effective date
Apr 1, 2022
We identified it
Jun 20, 2026
Summary
EmblemHealth has removed preauthorization requirements for certain speech therapy services (effective April 1, 2022) and CPT 29806 arthroscopy shoulder capsulorrhaphy services for non-NYC members (retroactive to January 1, 2022). These services no longer need prior authorization approval before billing.
Action Required
Immediately: Billing team must update EmblemHealth preauthorization requirements in billing system to remove prior auth for CPT 29806 (shoulder arthroscopy capsulorrhaphy) for non-City of New York members and specified speech therapy services. Update encounter forms and staff training materials to reflect these changes to avoid unnecessary authorization delays.