In 2019-
Under the Affordable Care Act, Emblem covers the following codes: G0442,G0443, G0444, G0445, G0446, G0446. When billing both E/M codes and the above mentioned G-codes, both modifier 25 and 59 have to be appended to the codes, respectively.
EmblemHealth will pay the claims with the above mentioned codes that have the appropriate above mentioned Modifiers retroactively to 07/15/2016.
Any claims billed on 11/12/2018 will be reviewed prospectively.
There is no need to resubmit the claims. All affected claims will be re-processed.
KR2 Medical Billing 