CommercialCoverageMedium impact
Follow-Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) Medication
Blue Cross Blue Shield of Rhode Island·RI · Pediatrics, Family Medicine, Psychiatry +1 more·Behavioral Health
Effective date
Mar 1, 2019
We identified it
Jun 20, 2026
Summary
BCBS Rhode Island has established specific requirements for follow-up care when prescribing ADHD medication to children ages 6-12. The policy requires one visit within 30 days of initial prescription and at least two additional visits within 9 months, with telephone consultation codes 98966-98968 and 99441-99443 accepted for continuation phase monitoring.
Action Required
Immediately: Providers prescribing ADHD medications to children ages 6-12 must schedule follow-up visits within 30 days of initial prescription and ensure at least two additional visits within 9 months. Billing team should note that telephone consultation codes 98966, 98967, 98968, 99441, 99442, and 99443 are covered but not separately reimbursed by BCBSRI for continuation phase requirements. Update scheduling protocols to automatically schedule required follow-ups when ADHD medications are prescribed.