Medicare AdvantageCoverageMedium impact
Payment policy updates
Blue Cross Blue Shield of Rhode Island·RI · OB-GYN, Pain Management·Physician / Facility
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
BCBS RI updated three payment policies: corrected claims for certain situations must now be submitted on paper, acupuncture services are no longer covered under Medicare Advantage plans effective January 1, 2026 (only chronic lower back pain remains covered), and CPT code 89258 has been removed from the alternate code list and now requires prior authorization under the Infertility Services Policy.
Action Required
By January 1, 2025: Billing team must update system to require prior authorization for CPT 89258 per Infertility Services Policy for both commercial and Medicare claims. By January 1, 2026: Stop billing acupuncture services for Medicare Advantage members except for chronic lower back pain. Update billing procedures to submit certain corrected claims on paper rather than electronically when specified situations apply.