CommercialPrior AuthMedium impact
Update to BCBSRI Notice of Admission Process
Blue Cross Blue Shield of Rhode Island·RI · Psychiatry·Behavioral Health
Effective date
Feb 5, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI is eliminating Notice of Admission requirements for Intensive Outpatient, CFIT, ABA, and TMS services effective February 5, 2024. This applies to Commercial and Medicare Advantage plans only, while medical necessity reviews still remain required for ABA and TMS services.
Action Required
By February 5, 2024: Billing team must update prior authorization workflows to stop submitting Notice of Admission for Intensive Outpatient mental health/substance use services, Child and Family Intensive Treatment (CFIT), Applied Behavior Analysis (ABA), and Transcranial Magnetic Stimulation (TMS) for BCBSRI Commercial and Medicare Advantage plans. Continue submitting medical necessity reviews for ABA and TMS services. Update billing system rules and staff training materials.