CommercialCoverageMedium impact
TMS Benefit is now considered a BH outpatient benefit
Blue Cross Blue Shield of Rhode Island·RI · Psychiatry·Behavioral Health / Facility
Effective date
Jul 3, 2023
We identified it
Jun 19, 2026
Summary
Effective July 3, 2023, all Transcranial Magnetic Stimulation (TMS) services are now processed as outpatient Behavioral Health benefits rather than under previous benefit categories. This affects billing classification for CPT codes 90867, 90868, and 90869.
Action Required
Immediately: Billing team must update system settings to process TMS services (CPT codes 90867, 90868, 90869) under outpatient Behavioral Health benefits instead of previous benefit categories. Update billing software benefit classification and verify patient eligibility under BH outpatient benefits for all TMS claims going forward.