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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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.
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