Summary
BCBS Rhode Island has issued a new policy on Joint Replacement procedures, effective September 1, 2026. The full policy text is available in the Provider section of BCBSRI.com under Medical Policy. Billing teams must review the complete policy document to identify specific coverage criteria, prior authorization requirements, and billing code updates for shoulder and other joint replacement procedures.
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What to do
by Aug 15, 2026 · 4 steps
01Billing team must access the full policy text at https://www.bcbsri.com/providers/update/new-policy-10 and review complete Joint Replacement policy details.
02Identify all affected CPT codes, HCPCS codes, prior authorization requirements, and medical necessity criteria.
03Update billing software, encounter forms, and prior authorization workflows accordingly.
04Train providers and front desk staff on new requirements.
If missed: Failure to implement required changes by September 1, 2026 will result in claim denials for joint replacement procedures.
Original notice
New policy
bcbsri.com · Always check the source before changing claims.