CommercialCoverageHigh 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 / Facility
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
BCBSRI will begin separately reimbursing Transitional Care Management, Chronic Care Management, and Principal Care Management services effective January 1, 2025. Nine specific codes will be covered and reimbursed, while four codes remain non-reimbursable.
Action Required
By January 1, 2025: Billing team must update billing system to enable separate billing for codes 99495, 99496, 99424, 99425, 99426, 99427, 99490, 99439, and G0506 for BCBSRI Commercial and Medicare Advantage plans. Ensure codes 99437, 99487, 99489, and 99491 remain bundled and not billed separately. Update encounter forms and provider documentation to support these care management services. Note: HSA-qualified HDHP members must meet deductible before no-cost coverage applies.