CommercialBilling CodesHigh impact
Telemedicine Modifier - Claims Edit Effective 9/1/26
Blue Cross Blue Shield of Rhode Island·RI · Psychiatry·Physician / Behavioral Health
Effective date
Sep 1, 2026
We identified it
Jul 1, 2026
Summary
Effective September 1, 2026, BCBS Rhode Island will implement a system edit to deny claims that combine telemedicine modifiers (93, 95, FQ, or GT) with place of service codes other than 02 (telehealth) or 10 (off-campus outpatient). Billing teams must ensure telemedicine modifiers are only used with appropriate telemedicine place of service codes to avoid claim denials.
Action Required
By August 31, 2026: Billing team must audit all telemedicine billing workflows and update billing system validation rules to prevent submission of claims with telemedicine modifiers (93, 95, FQ, GT) paired with place of service codes other than 02 or 10. Providers and billing staff should review encounter templates and documentation to ensure telemedicine modifiers are only appended when place of service 02 (telehealth) or 10 (off-campus outpatient facility) is selected. Implement pre-submission checks in billing software to flag mismatches. Effective September 1, 2026, any non-compliant claims will be automatically denied by BCBS Rhode Island's system edit, requiring resubmission and causing payment delays.