Medicare AdvantageBilling CodesMedium impact
CPT code changes
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 1, 2021
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated their CPT and HCPCS code coverage effective July 1, 2021. Multiple codes now have special coverage rules including codes that are not medically necessary for commercial products, subject to medical review for Medicare Advantage, not covered, or not separately reimbursed.
Action Required
Immediately: Billing team must update system rules for affected Category III CPT codes and PLA codes. Stop billing codes 0254U and 90758 (pharmacy benefit only) to BCBS RI. Mark codes 0662T and 0663T as bundled/non-separately reimbursed. Configure prior authorization requirements for code 0661T for all plans and codes 0640T-0660T, 0248U-0253U for Medicare Advantage plans only. Claims for these codes without proper authorization or billing rules will be denied.