Medicare AdvantageCoverageHigh impact
Removal of non-skilled benefit for Medicare Advantage Plans
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Effective January 1, 2025, BCBSRI removed the non-skilled benefit for all Medicare Advantage plans except BlueRI for Duals (D-SNP). Non-skilled services are now considered non-covered benefits and claims will be denied.
Action Required
Immediately: Billing team must stop billing non-skilled services to BCBSRI Medicare Advantage plans (except BlueRI for Duals D-SNP). Update billing system to flag these services as non-covered for BCBSRI MA plans. Verify patient plan type before service delivery. Claims for non-skilled services will be denied as non-covered benefits.