Medicare AdvantageCoverageMedium impact
Policy Updates
Blue Cross Blue Shield of Rhode Island·Family Medicine, Internal Medicine, General Practice +2 more·Provider Update
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Multiple policy updates from BCBSRI affecting behavioral health integration services, laboratory analyses, transitional care management, and vitamin D testing. Key changes include expanded coverage for CPT 99484 for commercial members, new reimbursement for transitional care codes for Medicare only, and restricted coverage for vitamin D testing requiring specific diagnosis codes.
Action Required
By July 1, 2019: Update billing system to restrict CPT codes 82306 and 82562 (Vitamin D Testing) to only specific ICD-10 diagnosis codes for commercial members. Billing team must verify diagnosis code requirements before submitting claims. For Medicare members, update system to allow separate reimbursement for CPT 99495 and 99496 (Transitional Care Management). For commercial members with behavioral health integration services, ensure CPT 99484 approval is obtained from BCBSRI before billing.