Summary
BCBSRI is implementing a claims processing edit effective October 1, 2026, requiring that all therapy service claims submitted with revenue codes 042X, 043X, or 044X must include the appropriate therapy modifier (GP for physical therapy, GO for occupational therapy, GN for speech-language pathology) appended to the CPT code. Claims missing the required modifier or with an incorrect modifier will be denied.
Get alerts when payers change rules like this one
We check Blue Cross Blue Shield of Rhode Island and other payers every day and email you when a change matches your specialty and state.
Get Blue Cross Blue Shield of Rhode Island alertsPolicy Monitoring is free. No card required.
What to do
by Sep 30, 2026 · 5 steps
01Billing team must update billing software to automatically append the correct therapy service modifiers (GP, GO, or GN) to all CPT codes submitted with revenue codes 042X, 043X, or 044X for SNF and HHA claims.
02Coordinate with providers and clinical staff to ensure therapy service designations are accurately documented in the EMR before claim submission.
03Implement a verification process to confirm correct modifier pairing before claims are transmitted to BCBSRI.
04Failure to append the required modifiers will result in claim denials effective October 1, 2026.
05Contact ProviderRelations@bcbsri.org with implementation questions.
Original notice
SNF HHA PT Coding
bcbsri.com · Always check the source before changing claims.