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Blue Cross Blue Shield of Rhode IslandCommercial · Billing Codes · Physician / Behavioral Health · RI · PsychiatryHigh impact

Telemedicine Modifier - Claims Edit Effective 9/1/26

Act
by Aug 31, 2026
Effective date
Sep 1, 2026
Identified
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.

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What to do

by Aug 31, 2026 · 4 steps
01Billing 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.
02Providers 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.
03Implement pre-submission checks in billing software to flag mismatches.
04Effective September 1, 2026, any non-compliant claims will be automatically denied by BCBS Rhode Island's system edit, requiring resubmission and causing payment delays.

Codes mentioned

9395FQGT

Original notice

Telemedicine Modifier - Claims Edit Effective 9/1/26
bcbsri.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross Blue Shield of Rhode Island changes →
Telemedicine modifier – Claims edit effective September 1, 2026HighEffective Sep 1, 2026 · Physician / Behavioral HealthTelemedicine Modifier - Claims Edit Effective September 1, 2026HighEffective Sep 1, 2026 · Physician / Behavioral HealthPayment policy updatesHighEffective Sep 1, 2026 · Provider UpdateTelemedicine Modifier - Claims Edit Effective 9/1/26HighEffective Sep 1, 2026 · Physician / Behavioral HealthBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list

Related policy hubs

Blue Cross Blue Shield of Rhode Island policiesRI policy changesPsychiatryCode 93Code 95Code FQCode GT

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