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Payment Policy Updates
Act
by Jul 1, 2025
Effective date
Jul 1, 2025
Identified
Jun 19, 2026
Summary
Multiple billing code updates effective July 1, 2025: 5 new immunization codes added, 4 codes deleted, 13 codes marked as non-reimbursable, new modifier requirements for off-campus institutional claims, and modifier 27 added for multiple outpatient E/M encounters.
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What to do
by Jul 1, 2025 · 5 steps
01Billing team must update system to include new immunization codes 90382, 90612, 90613, 90635, 91323.
02Remove deleted codes C9300, G9037, G9038, M0248 from billing system.
03Flag 13 T-codes as non-reimbursable (10 for all payers, 3 Medicare-only).
04Update UB-04 claims to require modifiers PO and PN for off-campus institutional services.
05Add modifier 27 for multiple outpatient E/M encounters on same date.
Codes mentioned
9038290612906139063591323C9300G9037G9038M0248
Original notice
Payment Policy Updates
bcbsri.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Rhode Island changes →CPT code changesMediumEffective Jul 1, 2025 · Physician / FacilityAdditional HCPCS Level II Code Changes and Modifier ChangesHighEffective Jul 1, 2024 · Physician / FacilityAdditional HCPCS Level II Code Changes and Modifier ChangesHighEffective Apr 1, 2025 · Physician / FacilityPayment PoliciesHighEffective Apr 1, 2025 · Physician / FacilityBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list