CommercialBilling CodesMedium impact
Payment policy updates
Blue Cross Blue Shield of Rhode Island·RI · Emergency Medicine·Physician / Facility
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
BCBSRI updated three policies: appeals for Emergency Department E&M claims denied by Optum should be sent to a new address, twelve new CPT codes were added to the non-reimbursable list effective July 1, 2025, and LCDPs are now individually credentialed as of February 1, 2025.
Action Required
By July 1, 2025: Billing team must update billing software to flag codes 0961T, 0962T, 0964T, 0965T, 0973T, 0974T, 0975T, 0976T, 0984T, 0985T, 0986T, 0987T as non-reimbursable by BCBSRI. Remove these codes from encounter forms and fee schedules. Update appeals process to send Emergency Department E&M claim appeals to new Optum address when denied by their designee.