Medicare AdvantageCoverageHigh impact
Medical policy updates
Blue Cross Blue Shield of Rhode Island·RI · Neurology, Ophthalmology, Endocrinology +5 more·Physician / Facility
Effective date
Jun 1, 2026
We identified it
Jun 19, 2026
Summary
Multiple policy changes effective June 1, 2026, including coverage expansions for remote electrical neuromodulation for migraines and diabetic retinal screening, new prior authorization requirements for bariatric procedures, and updates to genetic testing criteria. Several CPT codes are being moved between policies or having their coverage status changed.
Action Required
By June 1, 2026: Billing team must update system to reflect new coverage for CPT 92228 and 92229 for diabetic retinopathy screening in commercial plans. Update prior authorization requirements for CPT 0601T (all plans) and CPT 43847 for bariatric procedures. Remove CPT 55877 from focal prostate treatment policy and add to IRE tumor policy. Update genetic testing codes 81462, 81463, 81464 to use unlisted genetic testing criteria. Verify coverage changes for remote electrical neuromodulation services.