Medicare AdvantageBilling CodesMedium impact
CPT code changes
Blue Cross Blue Shield of Rhode Island·RI·Physician
Effective date
Apr 1, 2021
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated CPT and HCPCS code coverage and payment rules effective April 1, 2021. Specific codes now have new designations including medical review requirements, non-coverage determinations, and separate reimbursement restrictions.
Action Required
Immediately: Update billing system coverage rules for the specified HCPCS codes. Set codes C9074, J1554, J9037, J9349, Q2053 to require preauthorization for commercial products and BlueCHiP Medicare. Mark codes C9777, J1427, J7402, K1013, K1016, K1017, K1018, K1019, K1020, S1091 as non-covered/not medically necessary. Configure codes G2211, A9592, C9776, K1014, K1015 as non-separately reimbursable. Train staff to notify members of non-covered services before providing them.