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Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Gastroenterology, Radiology +1 more·Provider Update
Effective date
Sep 1, 2018
We identified it
Jun 20, 2026
Summary
BCBSRI is emphasizing the importance of site of service for cost savings, encouraging providers to consider non-hospital settings (ambulatory surgery centers, outpatient facilities) when clinically appropriate. The policy highlights significant cost differences between hospital and non-hospital settings for procedures like colonoscopy, knee arthroscopy, and brain MRI.
Action Required
Immediately: Providers should evaluate current procedures and consider non-hospital settings when clinically appropriate. Billing team should educate providers on cost differentials between hospital and outpatient settings. Discuss with patients the benefits of outpatient services and site-of-service payment differentials, especially for members with higher cost shares.