CommercialReimbursementMedium impact
Non-Reimbursable Health Service Codes
Blue Cross Blue Shield of Rhode Island·RI · Vascular Surgery, Cardiology, Radiology·Physician / Facility
Effective date
Jul 1, 2022
We identified it
Jun 19, 2026
Summary
CPT codes 37252 and 37253 will become separately reimbursable for commercial and Medicare Advantage plans when filed by professional providers in inpatient, outpatient, and emergency department settings only. These codes remain non-reimbursable in all other locations like office settings.
Action Required
By July 1, 2022: Billing team must update system rules to allow separate billing of CPT 37252 and 37253 for commercial and Medicare Advantage plans only when place of service is 21 (Inpatient), 22 (Outpatient), or 23 (Emergency Department). Ensure these codes are blocked for reimbursement in all other settings including office visits (POS 11). Update encounter forms and billing software accordingly.