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Additional HCPCS Level II Code Changes and Modifier Changes
Act
immediately
Effective date
Apr 1, 2024
Identified
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island has updated coverage and payment rules for multiple HCPCS Level II codes effective April 1, 2024. The changes include new covered codes, non-covered codes, and codes requiring medical review, with different rules for Commercial and Medicare Advantage plans.
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What to do
immediately · 5 steps
01Billing team must update system with new HCPCS code coverage rules effective April 1, 2024.
02Configure prior authorization requirements for codes G0138, J0177, J0589, J1202, J1203, J1323, J2782, J3055, J9248, C9168, J9249, J9376, Q5133, Q5134, and L5841.
03Mark codes E0152, E2298, H0051, A4293, S9002 as non-covered.
04Update encounter forms to alert providers about non-covered services notification requirements.
05Note that codes C9166, C9167, J2277 will require medical review starting May 1, 2024.
Codes mentioned
J0209J0577J0578J0650J0651J0652J1010J1434J2801J2919J3424J7165J7354J9073J9074J9075A9293E0152E2298H0051A4293S9002G0138J0177J0589J1202J1203J1323J2782J3055J9248C9168J9249J9376Q5133Q5134C9166C9167J2277L5841A4438A4593A4594E0736E0738E0739K1037A4271E2104C9796C9797Q4305Q4306Q4307Q4308Q4309Q4310A2026E0468S4988A4564L1320L5783
Original notice
Additional HCPCS Level II Code Changes and Modifier Changes
bcbsri.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Rhode Island changes →Medical policy updatesHighEffective Nov 1, 2024 · Physician / FacilityMedical policy updatesHighEffective Mar 1, 2025 · PhysicianPayment PoliciesHighEffective Apr 1, 2025 · Physician / FacilityMedical policy updatesHighEffective Jul 1, 2026 · 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 changesOncologyOrthopedicsPM&R (Physical Medicine & Rehab)Code J0209Code J0577Code J0578Code J0650Code J0651Code J0652Code J1010Code J1434Code J2801Code J2919Code J3424Code J7165Code J7354Code J9073Code J9074Code J9075Code A9293Code E0152Code E2298Code H0051Code A4293Code S9002Code G0138Code J0177Code J0589Code J1202Code J1203Code J1323Code J2782Code J3055Code J9248Code C9168Code J9249Code J9376Code Q5133Code Q5134Code C9166Code C9167Code J2277Code L5841Code A4438Code A4593Code A4594Code E0736Code E0738Code E0739Code K1037Code A4271Code E2104Code C9796Code C9797Code Q4305Code Q4306Code Q4307Code Q4308Code Q4309Code Q4310Code A2026Code E0468Code S4988Code A4564Code L1320Code L5783