Medicare AdvantageBilling CodesHigh impact
The COVID-19 vaccine: Keeping our members informed and payment policy updates
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Mar 1, 2021
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island updated COVID-19 vaccination billing policy requiring Medicare Advantage providers to submit vaccine and administration codes to Original Medicare instead of BCBS. E/M services should not be billed with vaccination unless separately identifiable with modifier 25.
Action Required
Immediately: For Medicare Advantage patients receiving COVID-19 vaccines in 2020-2021, billing team must submit vaccine and administration codes to Original Medicare, NOT to BCBS. Do not bill E/M services with vaccination unless service is separately identifiable and modifier 25 is appended. If vaccine codes are billed to BCBS, claims will be denied and providers cannot bill the member.