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Traditional MedicareCoverageMedium impact

Medical Technologies Database

EmblemHealth·Oncology, Gastroenterology, Urology +1 more·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

EmblemHealth has updated their medical technologies database with new 2021 CPT/HCPCS codes and coverage decisions. Several new procedures have been approved for coverage including FoundationOne Liquid CDx (Medicare only), POEM for swallowing disorders, and PCA3 prostate cancer screening (added Commercial coverage). Multiple technologies were rejected and are not covered.

Action Required

Action needed
Immediately: Review the updated Medical Technologies Database in Clinical Corner on the EmblemHealth provider website. Update prior authorization and coverage verification processes for newly approved procedures: FoundationOne Liquid CDx (Medicare patients only), per-oral endoscopic myotomy (POEM) for achalasia, and PCA3 prostate cancer screening (now covered for Commercial plans). Ensure rejected technologies are flagged as non-covered to prevent claim denials.

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