CommercialBilling CodesHigh impact
Payment Policies
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
Multiple payment policy updates effective April 1, 2025, including new preventive codes (0064U for syphilis screening, G0567), addition of many non-reimbursable codes, deletion of COVID-19 treatment codes, and updated DRG payment rules for deceased patients.
Action Required
Immediately: Update billing system to reflect codes effective April 1, 2025. Add CPT 0064U and G0567 as covered preventive services (0064U limited to once per calendar year). Configure system to deny or flag the extensive list of non-reimbursable codes (A2030-A2035, A6515-A6519, A6611, A9300, A9611, E0201, G0567, J1245, L-codes, Q4354-Q4367, S4024). Remove deleted codes L8010, S4988 and all COVID-19 treatment M-codes and Q-codes from billing options. Update inpatient DRG billing logic to use lower of DRG rate or actual charges for deceased patients. Billing team must verify all changes are implemented before submitting claims with these codes.