CommercialBilling CodesHigh impact
Adaptive Maintenance (new and revised codes) Addition
Blue Cross Blue Shield of Vermont·VT·Newsletter
Effective date
Jul 1, 2026
We identified it
Jun 27, 2026
Summary
Blue Cross VT released multiple urgent policy updates effective July 1, 2026 and August 1, 2026, including a new investigational code G0577, mandatory NDC/UoM/Quantity requirements for specific services, CAA Provider Directory Validation enforcement with claim denials, and archival of nutritional counseling policies replaced by new medical nutrition therapy policies. Additionally, maternity care coding will change January 1, 2027, requiring new CPT codes to replace the global maternity code.
Action Required
IMMEDIATE ACTIONS REQUIRED:
1. By July 1, 2026: Billing team must add code G0577 to the system and flag it as INVESTIGATIONAL (non-covered) under Blue Cross VT plans. Do not bill this code for covered services.
2. By July 3, 2026: Billing team must identify all service lines requiring NDC (National Drug Code), Unit of Measure (UoM), and Quantity fields per Blue Cross VT's full list. Update billing system to REQUIRE these three fields on all claims for these services submitted on or after July 3, 2026. Claims missing NDC/UoM/Quantity will be DENIED. Review the full list at https://www.bluecrossvt.org to identify affected services in your practice.
3. IMMEDIATE: Verify your practice completed the April 2026 CAA Provider Directory Validation within 30 days. Starting September 1, 2026, claims submitted under non-validated NPIs will be DENIED until validation is completed. Complete the July 1, 2026 validation when released (on/around July 4, 2026) within 30 days to avoid September denials. Access validation process at: https://www.bluecrossvt.org (Enrollment & Credentialing section) or call (888) 449-0443 option 2 or email CAA@bcbsvt.org.
4. By August 1, 2026: Billing and clinical staff must review and implement the new Medical Nutrition Therapy and Nutritional Counseling Medical Policy and Payment Policy (effective August 1, 2026). The old Nutritional Counseling Medical Policy is being archived. Update encounter forms, authorization templates, and billing rules accordingly. This impacts nutrition therapy billing and authorization workflows.
5. By January 1, 2027: Billing team must STOP billing the global maternity code on or after January 1, 2027. Identify replacement CPT codes from AMA guidance (referenced in policy). Update billing system rules, encounter forms, and provider education materials. Claims submitted with the global code after January 1, 2027 will be DENIED.
6. By August 1, 2026: Review updated payment policy format and medical/payment policy changes effective August 1, 2026. Update billing rules and prior authorization lists based on routine coding updates referenced in the policy.
7. Before October 1, 2026: Ensure practice is enrolled in Electronic Fund Transfer (EFT) payments by signing up at PayeeHub. After October 1, 2026, Blue Cross VT will no longer issue paper checks. Call PayeeHub Customer Care at (877) 882-0384 (Mon-Fri, 9 AM-8 PM EST) if enrollment assistance is needed.