CommercialCoverageMedium impact
UPDATE Regarding Additional HCPCS Code Changes for July 2024
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 2, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island introduced new HCPCS code J0175 effective July 2, 2024, with different coverage rules for Commercial vs Medicare Advantage plans. Commercial plans will not cover J0175 until October 1, 2024, while Medicare Advantage plans covered it initially but moved to medical review starting August 1, 2024.
Action Required
Immediately: Update billing system to reflect J0175 coverage rules - mark as non-covered for Commercial plans through September 30, 2024, then subject to medical review starting October 1, 2024. For Medicare Advantage plans, submit J0175 for medical review effective August 1, 2024. Billing team must notify Commercial members about non-coverage of J0175 prior to rendering services through September 30, 2024.