CommercialReimbursementMedium impact
Multiple Endoscopy-Pay Percent
EmblemHealth·Gastroenterology, General Surgery, ENT (Ear, Nose & Throat) +1 more·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth ConnectiCare now applies CMS guidelines for multiple endoscopy procedures performed on the same patient by the same provider on the same date. The policy automatically reduces payments using Relative Value Units when multiple base procedure codes in the same endoscopy family are billed together.
Action Required
Immediately: Billing team must review all endoscopy claims for EmblemHealth ConnectiCare patients to ensure proper coding when multiple endoscopic procedures are performed same day. Update billing software to flag multiple endoscopy codes for review before submission. Train staff on CMS multiple endoscopy guidelines to prevent automatic payment reductions.