CommercialCoverageMedium impact
Transitional care management, chronic care management, and principal care management services
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +2 more·Physician
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
BCBSRI will begin covering and separately reimbursing transitional care management, chronic care management, and principal care management services effective January 1, 2025. Nine specific codes (99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, G0506) will be reimbursable, while four codes (99437, 99487, 99489, 99491) remain non-reimbursable.
Action Required
By January 1, 2025: Billing team must update billing software to allow separate reimbursement for CPT codes 99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, and G0506 for BCBSRI network providers only. Ensure codes 99437, 99487, 99489, and 99491 remain flagged as non-separately reimbursable. Update encounter forms and provider documentation to reflect new billable care management services.