Effective Jan. 1, 2024, EmblemHealth expanded the populations eligible for Community Health Worker (CHW) services beyond pregnant and postpartum populations. CHW services are now available to all children under 21 years of age, adults with chronic conditions, justice-involved individuals, those with unmet health-related social care needs, and individuals experiencing community violence.
Covered CHW services include health advocacy, health education, and health navigation supports. Services must be recommended by a doctor or other health care provider, and billed by the supervising New York State Medicaid-enrolled:
- Clinic.
- Hospital outpatient departments (OPDs).
- Doctor.
- Midwife.
- Nurse Practitioner (NP).
- Psychologist.
- Licensed Clinical Social Worker (LCSW).
- Licensed Mental Health Counselor (LMHC).
- Licensed Marriage Family Therapist (LMFT).
Additional information can be found in the Community Health Worker Services Policy Manual.
JP 64624 3/2024
