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Blue Cross Blue Shield of Rhode IslandCommercial · Billing Codes · Physician / Facility · RIHigh impact

Payment Policy Updates

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

Summary

BCBS Rhode Island has implemented multiple billing code changes effective at various dates in 2024, including making CPT G2211 non-separately reimbursable (NSR) starting July 1, 2024, updating COVID-19 testing coverage rules for Medicare, and requiring new modifiers for physical/occupational therapy services. Several HCPCS codes have been added, terminated, or modified with specific coverage changes.

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What to do

by Jul 1, 2024 · 6 steps
01Billing team must update system to mark CPT G2211 as non-separately reimbursable (NSR) for both commercial and Medicare Advantage plans.
02Stop billing G2211 as a separate line item with E/M visits.
03By July 1, 2024: Update billing software to require CQ and CO modifiers when PTA/OTA services are provided.
04Immediately: Replace terminated HCPCS K1005 with A4287 for breast milk storage bags.
05Update system to allow H0038 billing with place of service 02 and 10 for telemedicine.
06Add new codes Q0224 and M0224 for PEMGARDA treatment and 0646U for Colosense Plus colorectal screening.

Codes mentioned

G2211992029920399204992059921199212992139921499215K1005A4287A4455H0038Q0224M0224

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 updatesHighEffective Jul 1, 2024 · Physician / FacilityTips and documentation standards for interactive complexity and psychotherapy with E/M servicesHighEffective Jul 1, 2026 · Behavioral HealthSplit billingHighEffective Jan 1, 2020 · Provider UpdateCoding and medical record documentation reminders for behavioral health claimsMediumEffective Jul 1, 2023 · 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 changesCode G2211Code 99202Code 99203Code 99204Code 99205Code 99211Code 99212Code 99213Code 99214Code 99215Code K1005Code A4287Code A4455Code H0038Code Q0224Code M0224

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