BCBSRI is committed to supporting primary care providers and is excited to announce additional reimbursable codes for Care Management services to ensure practices are supported in delivering these important services to members. 

Effective 1 de enero de 2025, Transitional Care Management, Chronic Care Management, and Principal Care Management services will be covered and separately reimbursed. These codes include 99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, and G0506.

The following codes will remain as not separately reimbursable: 99437, 99487, 99489, and 99491.

Transitional Care Management, Chronic Care Management, and Principal Care Management services will be covered under the office visit category when provided by network providers. These services are not covered if provided by non-network providers.

For Commercial and Medicare Advantage plans, (except health savings account (HSA) -qualified high deductible health plans [HDHPs]), member cost share will not apply to these services. However, for members in HSA-qualified HDHPs, the deductible must first be met; once the deductible is met, coverage without cost share will apply to these services.  

For more information related to this new Payment Policy, please click here.