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CommercialBilling CodesMedium impact

Private Duty Nursing – Change in claim submission

Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Sep 1, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

Effective September 1, 2020, Private Duty Nursing services must be billed using HCPCS code T1000 for approved services. This change applies only to commercial products as Private Duty Nursing is not covered under BlueCHiP Medicare.

Action Required

Action needed
Before September 1, 2020: Billing team must update system to use HCPCS code T1000 for all approved Private Duty Nursing services on commercial plans only. Remove any other codes previously used for these services. Continue obtaining prior authorization through MHK portal for commercial products.

Affected Billing Codes

T1000