Summary
BCBS Rhode Island has added Modifier 27 to their payment policies for distinguishing multiple outpatient hospital E/M encounters on the same date by different departments. This modifier applies only to hospital facility claims and can be used with specific outpatient E/M codes and observation services.
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What to do
by Mar 1, 2025 · 3 steps
01Hospital facility billing teams must update billing systems to allow Modifier 27 for multiple outpatient E/M encounters on same date when provided by different departments.
02Train staff to append Modifier 27 to eligible CPT codes (99202-99215, 99281-99285, G0463, 99217-99220, 99224-99226) for hospital facility claims only.
03Update encounter forms and billing software rules to include this modifier option.
Codes mentioned
9920299203992049920599211992129921399214992159928199282992839928499285G046399217992189921999220992249922599226
Original notice
Payment Policies
bcbsri.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Rhode Island changes →Payment Policy UpdatesMediumEffective Jan 1, 2025 · Physician / FacilityPayment policy updatesHighEffective Jul 1, 2024 · Physician / FacilityTips and documentation standards for interactive complexity and psychotherapy with E/M servicesHighEffective Jul 1, 2026 · Behavioral HealthSplit billingHighEffective Jan 1, 2020 · Provider UpdateBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list
Related policy hubs
Blue Cross Blue Shield of Rhode Island policiesRI policy changesEmergency MedicineFamily MedicineInternal MedicineCode 99202Code 99203Code 99204Code 99205Code 99211Code 99212Code 99213Code 99214Code 99215Code 99281Code 99282Code 99283Code 99284Code 99285Code G0463Code 99217Code 99218Code 99219Code 99220Code 99224Code 99225Code 99226