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Blue Cross Blue Shield of Rhode IslandCommercial · Reimbursement · Physician / Facility · RI · Emergency MedicineHigh impact

Payment policy updates

Act
by Jul 1, 2024
Effective date
Jul 1, 2024
Identified
Jun 19, 2026

Summary

BCBSRI is implementing two major changes: CPT G2211 will be considered NSR (not separately reimbursed) effective July 1, 2024 for both commercial and Medicare Advantage plans, and new Emergency Department E/M coding policies will enforce stricter review of ED facility claims for levels 1-5.

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What to do

by Jul 1, 2024 · 4 steps
01Billing team must stop billing CPT G2211 as a separate code for BCBSRI commercial and Medicare Advantage plans - claims will not be separately reimbursed.
02Update billing software to block G2211 for these plans.
03For ED facilities: Review current E/M coding practices for levels 1-5 as BCBSRI will begin auditing these codes based on patient complexity, diagnostic services, and resource utilization.
04Prepare documentation to support higher-level E/M codes and establish appeal processes for downgrades.

Codes mentioned

G221199202992039920499205992119921299213992149921599281992829928399284992859929199292

Original notice

Payment policy updates
bcbsri.com · Always check the source before changing claims.
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Related changes

See all Blue Cross Blue Shield of Rhode Island changes →
Payment Policy UpdatesMediumEffective Jan 1, 2025 · Physician / FacilityPayment PoliciesMediumEffective Mar 1, 2025 · FacilityPayment Policy UpdatesHighEffective Jul 1, 2024 · Physician / FacilityTips and documentation standards for interactive complexity and psychotherapy with E/M servicesHighEffective Jul 1, 2026 · Behavioral HealthBrowse 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 changesEmergency MedicineCode G2211Code 99202Code 99203Code 99204Code 99205Code 99211Code 99212Code 99213Code 99214Code 99215Code 99281Code 99282Code 99283Code 99284Code 99285Code 99291Code 99292

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