Medicare AdvantageCoverageMedium impact
Medical policy updates
Blue Cross Blue Shield of Rhode Island·RI · Oncology, Cardiology, Gastroenterology +3 more·Provider Update
Effective date
Mar 1, 2026
We identified it
Jun 19, 2026
Summary
Multiple medical policy updates effective between March-May 2026, including expanded covered diagnosis codes for various lab tests, changes to prior authorization requirements for certain genetic tests, and restrictions on who can perform psychological testing. Most changes expand coverage for existing CPT codes while some procedures move from prior auth to non-covered status.
Action Required
By March 1, 2026: Update billing system to reflect CPT 0601T remains in New Technology policy, not focal prostate treatments policy. By May 1, 2026: Update covered diagnosis lists for CPT codes 80074, 83700, 83701, 83704, 82378, and 86300 to include new covered codes for Medicare Advantage and commercial plans. Add new ICD-10 codes C53.1, C53.8, C53.9, Z84.A, Z85.4A, Z91.B as covered for CPT 86304. Change CPT 0591U and 0398U from prior authorization to non-covered status. Restrict psychological/neuropsychological testing billing to psychologists and pediatric neurodevelopmental specialists only. Update pharmacy vendor contact information for prior authorization requests.