CommercialCoverageMedium impact
Medical Policy Updates December 2021
EmblemHealth·Plastic Surgery, OB-GYN, Oncology +3 more·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare updated six medical policies in December 2021, including revisions to gender affirming surgery, infertility services, breast cancer radiation therapy, prostatic urethral lift, and septoplasty policies, plus retirement of genetic testing for frontotemporal dementia coverage. These policy changes affect coverage determinations and prior authorization requirements for affected procedures.
Action Required
Immediately: Billing team must download and review the updated EmblemHealth and ConnectiCare medical policies from the provider websites at emblemhealth.com. Update internal coverage determination guidelines for gender affirming surgery, infertility services, intraoperative radiation therapy for breast cancer, prostatic urethral lift, and septoplasty procedures. Remove genetic testing for frontotemporal dementia from covered services list as this policy has been retired.