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New Policy for Commercial Members in 2022: No Cost/Reduced Cost Drugs, Implants & Devices

Switch to:

New Policy for Commercial Members in 2022: No Cost/Reduced Cost Drugs, Implants & Devices

10/26/2021

Starting Jan. 1, 2022, the No Cost/Reduced Cost Drugs, Implants & Devices Reimbursement Policy will be applied to both inpatient and outpatient hospital services for both EmblemHealth and ConnectiCare commercial members in the same way that we have been processing Medicare claims since Jan. 1, 2020. This policy has coding guidelines for reporting drugs, devices, and/or implants with their associated procedures when obtained by the provider at full cost, no cost, or at a reduced cost.

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Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.