Medicare AdvantageCoverageMedium impact
CPT code changes
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Oct 1, 2021
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island implemented CPT and HCPCS code changes effective October 1, 2021, with specific coverage determinations for new codes. Multiple HCPCS codes (0255U-0284U and 0018M) are subject to medical review for Medicare Advantage plans and deemed not medically necessary for commercial products.
Action Required
Immediately: Billing team must update system to require prior authorization for HCPCS codes 0255U-0284U and 0018M for Medicare Advantage plans only. Mark these same codes as non-covered for commercial products - do not bill to patients as they are not separately reimbursed. Notify patients about non-covered services before rendering them as required for participating providers.