Medicare AdvantageCoverageMedium impact
Payment Policy Updates
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +2 more·Physician / Facility
Effective date
Mar 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage plans now allow up to two Annual Well Visits per calendar year instead of one. A new modifier 93 has been added for synchronous audio-only telemedicine services for both Commercial and Medicare Advantage plans. STI testing code 87801 can now be billed with multiple STI test codes on the same date of service.
Action Required
By March 1, 2026: Billing team must update system to allow scheduling and billing of second Annual Well Visits for Medicare Advantage patients within the same calendar year. Add modifier 93 to billing system for audio-only telemedicine encounters alongside existing modifier FQ options. Update edits to allow CPT 87801 to process with other STI test codes on same date of service.