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CommercialBilling CodesHigh impact

Payment policy updates

Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Sep 1, 2026
We identified it
Aug 1, 2026
Days to comply
31 days

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).

Action Required

Before Sep 1, 2026
By August 31, 2026: Billing team must implement system edits and workflow changes to prevent claim denials. (1) Update 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. (2) Providers 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. (3) Audit recent claims (last 90 days) for mismatched telemedicine modifiers and place of service codes; resubmit corrected claims before the effective date if applicable. (4) Add a checklist or prompt to the EHR/billing system reminding clinicians: telemedicine modifier = telemedicine place of service. Failure to comply will result in automatic claim denials starting September 1, 2026.

Affected Billing Codes

93
95
FQ
GT