Medicare AdvantageBilling CodesMedium impact
CPT code changes
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Oct 1, 2023
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island has implemented October 2023 CPT code changes effective October 1, 2023, affecting coverage and reimbursement rules for multiple new CPT codes. The update includes new codes that are covered and separately reimbursed, codes covered under pharmacy benefit only, codes deemed not medically necessary, and codes requiring medical review.
Action Required
Immediately: Billing team must update system with new CPT code coverage rules - mark codes 0402U, 0403U, 0404U, 0405U, 0406U, 0407U, 0409U, 0410U, 0413U, 0414U, 0415U, 0416U, 0418U, 0019M as covered and separately reimbursed; route codes 0408U, 0411U, 0419U to pharmacy benefit; flag code 0412U as not medically necessary; and configure code 0417U to require medical review/preauthorization. Update encounter forms and train staff on new coverage designations.