In Vitro Chemoresistance and Chemosensitivity Assays - Lab Benefit Program (LBM)
Defines EmblemHealth's reimbursement stance on in vitro chemotherapy sensitivity and resistance assays, specifying coverage limitations and applicability based on member benefits and state/federal regulations for billed laboratory testing.
Lab Benefit Program (LBM) expanded to include EmblemHealth HMO/PPO (Non-City) Commercial, Medicare and Medicaid plans effective 10/1/2024.
HCPCS code 0435U was added to the Applicable CPT/HCPCS Procedure Codes table effective 3/15/2025 (noted in a ConnectiCare revision).
Several codes (0564T, 0083U, 0248U, 0249U, 0285U, 0435U, 0285U and 0525U) were removed from the Applicable CPT/HCPCS Procedure Codes table.
Policy content transferred to individual company-branded template; reformatted and reorganized with a new reimbursement policy number (ConnectiCare notes of prior transfers).
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.