Traditional MedicarePrior AuthMedium impact
MHK Updates
Blue Cross Blue Shield of Rhode Island·RI · Ophthalmology, Plastic Surgery, Sleep Medicine +2 more·Physician / Facility
Effective date
Mar 1, 2024
We identified it
Jun 19, 2026
Summary
Effective March 1, 2024, BCBS RI is removing prior authorization requirements for several procedure types: eyelid lesion excision, sleep studies (Medicare only), renal radiofrequency/cryoablation procedures, and TMJ reconstruction procedures. This simplifies billing workflows by eliminating the need to obtain prior auth for these specific codes.
Action Required
By March 1, 2024: Billing team must update prior authorization workflows to stop requiring prior auth for CPT codes 95808, 95810, 95811 (Medicare only), 50250, 50542 (Medicare and Commercial), and 21050, 21070 (Medicare and Commercial). Update billing system settings and staff procedures to reflect these changes to avoid unnecessary authorization delays.