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Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Pediatrics, OB-GYN·Physician
Effective date
Sep 1, 2021
We identified it
Jun 19, 2026
Summary
BCBS RI updated HEDIS well-child assessment requirements for children ages 3-17, specifying documentation standards for nutrition counseling, physical activity counseling, and BMI percentile recording. The policy provides specific billing codes for well-child counseling services and emphasizes structured EMR documentation.
Action Required
Immediately: Billing team must update EMR templates to include structured fields for nutrition counseling, physical activity counseling, and BMI percentile documentation for pediatric patients ages 3-17. Providers must use appropriate counseling codes (CPT 97802-97804, HCPCS G0270, G0271, G0447, S9449, S9452, S9470, S9451) in addition to E&M codes during well-child visits. Update encounter forms to remind providers of required HEDIS documentation elements.