CommercialBilling CodesMedium impact
Payment Policy Updates
Blue Cross Blue Shield of Rhode Island·RI · Emergency Medicine·Physician / Facility
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Effective January 1, 2025, BCBS Rhode Island has added modifier 27 to indicate multiple outpatient hospital E/M encounters on the same date. This modifier distinguishes separate E/M services provided by different departments in the same hospital and only applies to hospital facility claims (POS 22).
Action Required
Immediately: Hospital billing teams must update billing systems to append modifier 27 to E/M codes (99202-99215, 99281-99285, G0463, 99217-99220, 99224-99226) when multiple outpatient E/M encounters occur on the same date in different hospital departments. This only applies to hospital facility claims with place of service 22. Update billing software rules and train staff on proper modifier usage.