CommercialCoverageMedium impact
New policies
Blue Cross Blue Shield of Rhode Island·RI · Oncology, Orthopedics, Endocrinology +1 more·Physician / Facility
Effective date
Jun 1, 2019
We identified it
Jun 20, 2026
Summary
BCBS Rhode Island has created multiple new medical policies effective June 1, 2019, covering various drugs and procedures including specialty medications, spine procedures, and billing modifier requirements. Healthcare practices must review the full policy texts on the BCBS RI provider website to understand specific coverage criteria and documentation requirements.
Action Required
Immediately: Review all new policies listed in the Provider section of bcbsri.com under Medical Policies. Billing team must verify coverage criteria for specialty medications (Aliqopa, Crysvita, Libtayo, Onpattro, Poteligeo), update procedures for kyphoplasty/vertebroplasty claims, ensure proper use of modifier codes (59, XE, XP, XS, XU), and verify ordering provider NPI number requirements are met on all applicable claims.