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Blue Cross Blue Shield of Rhode IslandCommercial · Billing Codes · Provider Update · RIHigh impact

Payment policy updates

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

Summary

Effective September 1, 2026, claims submitted with telemedicine modifiers (93, 95, FQ, or GT) combined with in-office place of service codes (anything other than 02 or 10) will be automatically denied. Billing teams must ensure telemedicine modifiers are only used when place of service is coded as 02 (telehealth) or 10 (off-campus outpatient).

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What to do

by Aug 31, 2026 · 5 steps
01Billing team must implement system edits and workflow changes to prevent claim denials.
02Update billing software to flag or reject any claims combining telemedicine modifiers (93, 95, FQ, GT) with place of service codes other than 02 or 10 before submission.
03Providers and front desk staff must be trained to use telemedicine modifiers ONLY when place of service is documented as 02 or 10 on encounter forms and superbills.
04Audit recent claims (last 90 days) for mismatched telemedicine modifiers and place of service codes; resubmit corrected claims before the effective date if applicable.
05Add a checklist or prompt to the EHR/billing system reminding clinicians: telemedicine modifier = telemedicine place of service.
If missed: Failure to comply will result in automatic claim denials starting September 1, 2026.

Codes mentioned

9395FQGT

Original notice

Payment policy updates
bcbsri.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross Blue Shield of Rhode Island changes →
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Related policy hubs

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

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