All PlansBilling CodesMedium impact
Payment Policies
Blue Cross Blue Shield of Rhode Island·RI · Emergency Medicine, Family Medicine, Internal Medicine·Facility
Effective date
Mar 1, 2025
We identified it
Jun 19, 2026
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.
Action Required
By March 1, 2025: Hospital 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. Train staff to append Modifier 27 to eligible CPT codes (99202-99215, 99281-99285, G0463, 99217-99220, 99224-99226) for hospital facility claims only. Update encounter forms and billing software rules to include this modifier option.