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CommercialCoverageHigh impact

Transitional care management, chronic care management, and principal care management services

Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +2 more·Physician
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSRI will now separately reimburse transitional care management, chronic care management, and principal care management services effective January 1, 2025. Nine specific CPT codes (99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, G0506) are now billable separately, while four codes remain non-reimbursable.

Action Required

Action needed
Immediately: Billing team must update system to allow separate billing for CPT codes 99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, and G0506 for BCBSRI members. Ensure codes 99437, 99487, 99489, and 99491 remain flagged as non-separately reimbursable. Update encounter forms to reflect new billable care management services. Verify network provider status as these services are not covered for non-network providers.

Affected Billing Codes

99495
99496
99424
99425
99426
99427
99490
99439
G0506
99437
99487
99489
99491