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Medicare AdvantageBilling CodesHigh impact

CPT code changes

Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

Blue Cross Blue Shield of Rhode Island has updated their CPT code coverage and payment rules effective July 1, 2024. The update includes new codes that are covered, others requiring medical review or prior authorization, and some that are not separately reimbursed, with different rules for Medicare Advantage vs Commercial products.

Action Required

Action needed
Immediately: Billing team must update billing system to reflect new CPT code rules effective July 1, 2024. Configure codes 90637, 90638, 90684, 0464U, 0889T, 0890T, 0891T, 0892T as covered and separately reimbursed. Set up prior authorization requirements for codes 0867T-0888T, 0897T-0898T (Medicare Advantage only) and codes 0450U-0475U, 0020M, 0874T, 0876T, 0899T, 0900T (all plans). Flag codes 0877T-0883T, 0887T, 0893T-0898T as not separately reimbursed. Update encounter forms to alert providers of medical review requirements. Providers must notify members about non-covered services prior to rendering them.

Affected Billing Codes

90637
90638
90684