CommercialCoverageMedium impact
Follow-up care for children prescribed attention deficit hyperactivity disorder (ADHD) medication
Blue Cross Blue Shield of Rhode Island·RI · Psychiatry, Pediatrics, Family Medicine·Behavioral Health
Effective date
Dec 1, 2018
We identified it
Jun 20, 2026
Summary
BCBS Rhode Island updated follow-up care requirements for children prescribed ADHD medication, specifying that telephone consultation codes 98966-98968 and 99441-99443 can satisfy continuation phase requirements but are covered without separate reimbursement. The policy emphasizes scheduling follow-up visits within 30 days of initial prescription and two additional visits within 9 months.
Action Required
Immediately: Billing team must update systems to reflect that telephone codes 98966, 98967, 98968, 99441, 99442, and 99443 are covered but not separately reimbursed by BCBSRI for ADHD follow-up care. Providers should schedule required follow-up visits (one within 30 days, two additional within 9 months) and document that telephone consultations can satisfy continuation phase requirements without generating separate revenue.