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Blue Cross Blue Shield of Rhode IslandCommercial · Coverage · Physician / Facility · RI · Family Medicine, Internal Medicine, General Practice +2 moreHigh 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 separately reimbursing Transitional Care Management, Chronic Care Management, and Principal Care Management services effective January 1, 2025. Nine specific codes will be covered and reimbursed, while four codes remain non-reimbursable.

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What to do

by Jan 1, 2025 · 4 steps
01Billing team must update billing system to enable separate billing for codes 99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, and G0506 for BCBSRI Commercial and Medicare Advantage plans.
02Ensure codes 99437, 99487, 99489, and 99491 remain bundled and not billed separately.
03Update encounter forms and provider documentation to support these care management services.
04Note: HSA-qualified HDHP members must meet deductible before no-cost coverage applies.

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.
View original ↗

Related changes

See all Blue Cross Blue Shield of Rhode Island changes →
Transitional Care Management, Chronic Care Management, and Principal Care Management servicesMediumEffective Jan 1, 2025 · PhysicianTransitional care management, chronic care management, and principal care management servicesMediumEffective Jan 1, 2025 · PhysicianTransitional care management, chronic care management, and principal care management servicesHighEffective Jan 1, 2025 · PhysicianCPT code changesHighEffective Jan 1, 2022 · Physician / FacilityBrowse 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 changesFamily MedicineInternal MedicineGeneral PracticePediatricsGeriatricsCode 99495Code 99496Code 99424Code 99425Code 99426Code 99427Code 99490Code 99439Code G0506Code 99437Code 99487Code 99489Code 99491

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