CommercialAdministrativeMedium impact
PCP Quality Incentive Program (PQIP) 2023 program updates and changes
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +1 more·Physician
Effective date
Feb 1, 2023
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island updated their Primary Care Provider Quality Incentive Program (PQIP) for 2023, expanding age ranges for existing measures and adding new quality measures including kidney evaluation for diabetes patients, osteoporosis management, lead screening, and chlamydia screening. The changes affect both commercial and Medicare populations with specific CPT and LOINC codes identified for proper documentation and billing.
Action Required
Billing team should update encounter forms and EMR templates to include the new kidney evaluation measure codes (CPT 80047, 80048, 80050, 80053, 80069, 82565 for eGFR and CPT 82043, 82570 for urine albumin/creatinine) for diabetic patients ages 18-85. Ensure urine albumin and creatinine tests are performed within 4 days of each other. Update quality reporting workflows to capture expanded colorectal screening age range (45-75) and new pediatric measures for lead and chlamydia screening.