CommercialCoverageMedium impact
2023 Benefit Changes
Blue Cross Blue Shield of Rhode Island·RI · Psychiatry, Podiatry, PM&R (Physical Medicine & Rehab)·Provider Update
Effective date
Jan 1, 2023
We identified it
Jun 19, 2026
Summary
BCBSRI is implementing multiple benefit changes effective January 1, 2023, including elimination of prior authorization for certain out-of-network behavioral health services (replaced with notice requirements), expanded routine foot care coverage beyond diabetes, increased hearing aid benefits with age distinctions removed, elimination of copays for methadone maintenance, and new coverage for stander devices with prior authorization.
Action Required
Before January 1, 2023: Billing team must update prior authorization workflows to replace behavioral health prior auths with notice of admission/discharge processes for out-of-network inpatient, partial hospitalization, intensive outpatient, TMS, and intensive services. Update foot care billing to include expanded diagnoses beyond diabetes (metabolic, neurologic, peripheral vascular disease). Adjust hearing aid benefit limits to $1,500 for all plans ($2,000 for NEHP) regardless of age. Remove copays for methadone maintenance billing. Add prior authorization requirements for stander DME devices.