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Blue Cross Blue Shield of Rhode IslandCommercial · Billing Codes · Physician / Behavioral Health · RI · PsychiatryHigh impact

Telemedicine modifier – Claims edit effective September 1, 2026

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

Summary

Effective September 1, 2026, Blue Cross Blue Shield Rhode Island will implement a system-level claims edit that denies any claims submitted with telemedicine modifiers (93, 95, FQ, or GT) unless paired with place of service code 02 or 10. Practices must immediately audit billing workflows to ensure telemedicine modifiers are only used when the appropriate telemedicine place of service is documented to avoid claim denials.

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What to do

by Aug 31, 2026 · 7 steps
01Billing team must implement system edits and manual verification procedures to prevent submission of claims containing telemedicine modifiers (93, 95, FQ, GT) with place of service codes other than 02 (telehealth - patient home) or 10 (telehealth - patient's location).
02Update billing software validation rules to flag or block non-compliant combinations.
03Audit all existing encounter templates and standing orders to remove telemedicine modifiers from in-office visit types.
04Train providers and clinical staff on correct modifier usage—telemedicine modifiers must ONLY be used when POS 02 or 10 is selected.
05Review recent claims (past 90 days) for non-compliant billing patterns and resubmit with corrections if needed.
06Consequences: Claims billed with telemedicine modifiers and incorrect place of service will be automatically denied by BCBS RI system starting September 1, 2026, resulting in revenue loss and delayed reimbursement.
07Contact ProviderRelations@bcbsri.org with questions.

Codes mentioned

9395FQGT

Original notice

Telemedicine modifier – Claims edit effective September 1, 2026
bcbsri.com · Always check the source before changing claims.
View original ↗

Related changes

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Related policy hubs

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

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