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Additional CPT® Code Changes
Act
by Jul 1, 2026
Effective date
Jul 1, 2026
Identified
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated CPT code coverage and payment rules for July 2026, affecting dozens of new codes with varying coverage levels including covered services, medical review requirements, and non-covered services depending on plan type. The changes include new laboratory codes (0636U-0659U), vaccine codes (90616, 90639), and Category T codes with different rules for Medicare Advantage vs Commercial products.
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What to do
by Jul 1, 2026 · 2 steps
01Billing team must update system to reflect new CPT code coverage rules - codes 0636U-0639U, 90616, 90639, 1051T-1053T are covered and separately reimbursed; codes 0631U-0659U require medical review/preauthorization for covered plans but are not covered for Commercial Opt-Out groups; codes 1026T, 1027T, 1036T-1038T, 1040T, 1050T require medical review for Medicare Advantage only and are not medically necessary for Commercial; codes 1028T-1049T are not separately reimbursed.
02Update billing software rules and train staff on plan-specific coverage differences.
Codes mentioned
9061690639
Original notice
Additional CPT® Code Changes
bcbsri.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Rhode Island changes →Payment policy updatesMediumEffective Jul 1, 2026 · Physician / FacilityAdditional CPT® Code ChangesMediumEffective Oct 1, 2026 · Physician / FacilityCPT® and HCPCS Level II code changesMediumEffective Jul 1, 2018 · Physician / FacilityCPT® and HCPCS Level II code changesHighEffective Jan 1, 2019 · Physician / FacilityBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list