Medicare AdvantageCoverageMedium impact
Policy updates
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Oct 1, 2023
We identified it
Jun 19, 2026
Summary
Multiple policy updates are taking effect with different dates: EndeavorRx digital therapy remains non-covered for ADHD, new Lyme disease testing codes become covered, interprofessional consultation codes are now reimbursable, and Rhode Island mammogram screening mandates begin in 2024.
Action Required
By October 1, 2023: Billing team must update system to allow billing of CPT codes 99446, 99447, 99448, 99449, and 99451 for interprofessional consultations. By November 1, 2023: Stop billing G0176 for activity therapy in partial hospitalization programs. By December 1, 2023: Update coverage rules to mark CPT codes 0043U and 0044U as covered for Lyme disease testing on both Medicare Advantage and commercial plans, and ensure EndeavorRx treatments are denied as not medically necessary.