Medicare AdvantagePrior AuthMedium impact
1/1/2024 Updates
Blue Cross Blue Shield of Rhode Island·RI · Physical Therapy, Occupational Therapy, Psychiatry·Physician / Facility
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Effective January 1, 2024, BCBS Rhode Island is removing referral requirements for Physical Therapy and Occupational Therapy for Medicare Advantage and Commercial plans, and for Speech Therapy for Medicare Advantage only. Mental Health Counselors and Marriage and Family Therapists can now render services to Medicare members.
Action Required
Immediately: Update billing system and authorization workflows to remove referral requirements for Physical Therapy and Occupational Therapy services for Medicare Advantage and Commercial patients. Remove referral requirements for Speech Therapy for Medicare Advantage patients only. Front desk staff should update scheduling protocols to no longer require referrals for these services. Billing team should verify that Mental Health Counselors and Marriage and Family Therapists can now bill for Medicare member services.