Summary
Effective October 1, 2026, BCBSRI will enforce a coding edit requiring therapy service modifiers (GP for physical therapy, GO for occupational therapy, GN for speech-language pathology) to be appended to CPT codes when billing with SNF/HHA therapy revenue codes 042X, 043X, or 044X. Claims missing the required modifier or containing 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 · 6 steps
01Billing team must update billing system to automatically append or require the appropriate therapy modifier (GP, GO, or GN) to all CPT codes submitted with revenue codes 042X, 043X, or 044X for BCBSRI claims.
02Audit all SNF and HHA therapy claims currently in workflow to identify and correct any missing or incorrect modifiers before the effective date.
03Train providers and clinical staff to ensure proper modifier assignment at point of service.
04Update claim submission templates and verification processes to validate modifier-to-service alignment.
05Failure to include the correct modifier will result in claim denials on or after October 1, 2026.
06Contact ProviderRelations@bcbsri.org with implementation questions.
Original notice
SNF HHA PT Coding
bcbsri.com · Always check the source before changing claims.