CMS released a new code J0175 effective 2 de juliond, 2024. These updates will be added to our claims processing system and are effective 2 de juliond, 2024.  

Please submit your comments and concerns regarding coverage and payment designations to: 

Blue Cross & Blue Shield of Rhode Island 

Attention: Medical Policy, HCPCS review 

500 Exchange Street 

Providence, Rhode Island 02903 

Please note that as a participating provider, it is your responsibility to notify members about non-covered services prior to rendering them. 

Revised 20 de julio24 HCPCS Updates: 

Please note: Coverage and/or payment rules for code(s) below may be subject to change for Medicare Advantage Plans and/or Commercial Products. 

Commercial Products:

New HCPCS Code J0175 will be not covered for Institutional and Professional providers for Commercial Products effective for dates 07/2/2024 through 09/30/2024. 

Effective starting on 10/1/2024, J0175 will be subject to medical review for both Professional and Institutional providers (Pharmacy Benefit) for Commercial Products. 

Medicare Advantage Plans: 

New HCPCS Code J0175 will be covered and separately reimbursed for Institutional and Professional providers for Medicare Advantage Plans, effective for dates 07/2/2024 through 07/31/2024. 

Effective starting on 08/1/2024, HCPCS Code J0175 will be subject to medical review for Professional and Institutional providers (Pharmacy Benefit) for Medicare Advantage Plans.