All PlansCoverageHigh impact
Payment Policy Updates
Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Physical Therapy, Occupational Therapy·Physician / Facility
Effective date
Oct 1, 2026
We identified it
Oct 1, 2026
Summary
Effective October 1, 2026, Blue Cross Blue Shield Rhode Island has added 24 specific HCPCS and CPT codes to their non-reimbursable services list. Thirteen codes (A2046-A2050, A4228, A9613, E0788, L8697, Q4207, Q4223, Q4243) will be denied for facility claims only, while ten codes (T1069-T1078) will be denied for both professional and facility claims across all lines of business. Two orthotic codes (L1330, L1972) will be denied for professional and facility claims but remain reimbursable for DME professionals.
Action Required
By October 1, 2026: Billing team must immediately update all billing system edits and claim scrubbing software to deny the following codes: A2046, A2047, A2048, A2049, A2050, A4228, A9613, E0788, L8697, Q4207, Q4223, Q4243 for all facility claims; and T1069-T1078, L1330, L1972 for all professional and facility claims across all BCBS RI lines of business. Configure system to flag these codes before submission and prevent batching. For L1330 and L1972: allow reimbursement ONLY when billed by DME professionals—configure system to route these claims differently based on billing provider type. Front desk and coding staff must be trained on the new denials. Failure to implement these edits will result in claim denials and payment delays for affected services.