Summary
Effective January 1, 2025, BCBS Rhode Island has added modifier 27 to indicate multiple outpatient hospital E/M encounters on the same date. This modifier distinguishes separate E/M services provided by different departments in the same hospital and only applies to hospital facility claims (POS 22).
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What to do
immediately · 3 steps
01Hospital billing teams must update billing systems to append modifier 27 to E/M codes (99202-99215, 99281-99285, G0463, 99217-99220, 99224-99226) when multiple outpatient E/M encounters occur on the same date in different hospital departments.
02This only applies to hospital facility claims with place of service 22.
03Update billing software rules and train staff on proper modifier usage.
Codes mentioned
9920299203992049920599211992129921399214992159928199282992839928499285G046399217992189921999220992249922599226
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 →Payment PoliciesMediumEffective Mar 1, 2025 · 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 MedicineCode 99202Code 99203Code 99204Code 99205Code 99211Code 99212Code 99213Code 99214Code 99215Code 99281Code 99282Code 99283Code 99284Code 99285Code G0463Code 99217Code 99218Code 99219Code 99220Code 99224Code 99225Code 99226