Summary
Effective April 1, 2026, HCPCS Code C8010 will be covered for Medicare Advantage Plans, but will continue to be considered not medically necessary for Commercial Products. This creates a split coverage policy where the same code has different coverage status depending on the plan type.
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What to do
Action · 2 steps
01Before April 1, 2026: Billing team must update billing system to reflect C8010 coverage differences by plan type - set as covered for Medicare Advantage plans and not medically necessary for Commercial plans.
02Update encounter forms and train staff on plan-specific coverage rules to avoid claim denials.
Codes mentioned
C8010
Original notice
HCPCS Code C8010
bcbsri.com · Always check the source before changing claims.