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Blue Cross Blue Shield of Rhode IslandCommercial · Coverage · Physician · RI · Family Medicine, Internal Medicine, General Practice +2 moreMedium impact

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

Act
by Jan 1, 2025
Effective date
Jan 1, 2025
Identified
Jun 19, 2026

Summary

BCBSRI will begin covering and separately reimbursing transitional care management, chronic care management, and principal care management services effective January 1, 2025. Nine specific codes (99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, G0506) will be reimbursable, while four codes (99437, 99487, 99489, 99491) remain non-reimbursable.

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What to do

by Jan 1, 2025 · 3 steps
01Billing team must update billing software to allow separate reimbursement for CPT codes 99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, and G0506 for BCBSRI network providers only.
02Ensure codes 99437, 99487, 99489, and 99491 remain flagged as non-separately reimbursable.
03Update encounter forms and provider documentation to reflect new billable care management services.

Codes mentioned

9949599496994249942599426994279949099439G050699437994879948999491

Original notice

Transitional care management, chronic care management, and principal care management services
bcbsri.com · Always check the source before changing claims.
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