Posted in #reimbursement, EmblemHealth NY, Payer Updates, Prior Authorization Insurance Carrier Updates, Training

Emblem Health to add more DME codes to prior auth list.

Are you a a DME provider or a physician that prescribes DME for Emblem Health members? Then this blog post is for you!

Starting on for any DOS 13,2026 and thereafter the following DME codes will be added to the prior authorization list.


If you find this type of content useful? Follow my blog for more!


Posted in MVP (NY/VT) Insurance Payer, NY Providers, Training, Updates

MVP NY Medicaid Plans: Medical Devices and Supplies coverage change

This policy applies to MVP NY Medicaid Plans and their coverage for Medical Devices and Supplies.

The following examples are not all inclusive, that apply to this policy:

  1. Foot Care products: insoles, massagers, arch supports
  2. Pill Splitters
  3. Body weight scales
  4. Pulse Oximeters
  5. Thermometer’s (only oral, rectal and basal are covered)
  6. Wheelchair products
  7. Medical fridges
  8. Commodes
  9. Transfer benches
  10. Safety rails (bed, wall, bath)
  11. Fetal dopplers
  12. Bath/shower/toilet sears
  13. Sharp’s containers
  14. Ear Plugs
  15. Nasal dilator strips
  16. Cushions
  17. Decompression belts
  18. Reaches
  19. Travel Coolers etc
Picture Via Cumberland ME

MVP is aligning with NY Medicaid Fee for Services DME coverage. Devices or supplies that are NOT COVERED under FFS Medicaid “Pharmacy Fee Schedule” will continue to not be covered. Applicable DME Products should be billed under the member’s DME Benefit.


For complete list of NY MEDICAID DME COVERED and NON-COVERED Products, please click here.


Find this type of content helpful? Follow my blog for more medical billing and coding guidelines, reimbursement/medical policy updates and any other healthcare field related news.


Recent Blog Posts: