Prenatal Screening (Nongenetic) Lab Benefit Program (LBM)
Defines coverage, indications, and limitations for routine nongenetic prenatal laboratory screening tests under EmblemHealth's Lab Benefit Management program; applies to providers submitting claims for prenatal screening services.
Removed CPT code 87592 from Applicable CPT/HCPCS Procedure Codes table effective 8/13/2025.
Addition of CPT code 87389 to the Applicable CPT/HCPCS Procedure Codes table.
Removal of CPT codes 83020, 83021, 86702, 86703, G0432, G0433, G0435, and 0167U from the Applicable CPT/HCPCS Procedure Codes table.
Updated recommended testing type for HIV and other coverage criteria, and clarified coverage in relation to setting.
Lab Benefit Program (LBM) expanded to include EmblemHealth HMO/PPO (Non-City) Commercial, Medicare and Medicaid plans effective 10/1/2024.
Transferred policy content to individual company-branded template; reformatted and reorganized policy.
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.