NYSHIP (New York State Health Insurance Program) change in immunization claim submissions

Effective for dates of service on or after January 1, 2020, Empire BlueCross (“Empire”) will consider claims for NYSHIP members receiving immunizations in an outpatient hospital setting.

 

For dates of service prior to January 1, 2020, claims should be submitted to United Health Care (UHC), NYSHIP’s medical benefit administrator.

 

All claims will be subject to standard medical necessity guidelines and contract limitations.