- P = Professional
 - B = Behavioral health
 - F = Facilities
 
Policies
    P        F  
    Nov 1, 2025
  
    COVID-19 Monoclonal Antibody Treatment and Antiviral IV MedicationsThis policy was updated to correc...
  
    P        F  
    Nov 1, 2025
  
    *NEW POLICY* Prior Authorization of Physical and Occupation Therapy ServicesEffective January 1, 202...
  
    P        F  
    Nov 1, 2025
  
    The following policies were recently reviewed for annual update. The full texts of these policies ar...
  
    P        F  
    Nov 1, 2025
  
    The following new policies were created. Effective dates vary so please review the full text of thes...
  
    P    B    F  
    Nov 1, 2025
  
    BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...
  
    P        F  
    Oct 1, 2025
  
    We have completed our review of the October 2025 Healthcare Common Procedure Coding System (HCPCS) c...
  
    P    B    F  
    Oct 1, 2025
  
    Preventative Services for Commercial Members policyThis policy was updated to meet HRSA guidelines e...
  
    P        F  
    Oct 1, 2025
  
    Cranial Orthoses (Adjustable) for Positional Plagiocephaly and Craniosynostoses   &nb...
  
    P        F  
    Oct 1, 2025
  
    The following policies were recently reviewed for annual update. The full texts of these policies ar...
  
    P        F  
    Oct 1, 2025
  
    The following new policies were created. Effective dates vary so please review the full text of thes...
  
    P    B    F  
    Oct 1, 2025
  
    BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...
  
    P          
    Sep 1, 2025
  
    We have updated the verbiage in this policy to read: BCBSRI requires claims for lactation consultati...
  
    P        F  
    Sep 1, 2025
  
      Effective 11/1/2025, this policy will be updated to include Fully-Funded Commercial Products....
  
    P        F  
    Sep 1, 2025
  
    Prior authorization via web-based tool for proceduresEffective October 1, 2025, the following CPT/HC...
  
    P        F  
    Sep 1, 2025
  
    The following policies were recently reviewed for annual update. The full texts of these policies ar...
  
    P    B    F  
    Sep 1, 2025
  
    BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...
  
    P        F  
    Aug 1, 2025
  
    Laboratory Tests Post Transplant and for Heart Failure Effective August 1, 2025:   CP...
  
    P        F  
    Aug 1, 2025
  
    The following policies were recently reviewed for annual update. The full texts of these policies ar...
  
    P        F  
    Aug 1, 2025
  
    The following new medical policy was created: Acute Hepatitis Panel – Effective October 1, 2025...
  
    P    B    F  
    Aug 1, 2025
  
    BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...
  
    P        F  
    Aug 1, 2025
  
    We have completed our review of the October 2025 CPT code changes, including any category II perform...
  
    P        F  
    Aug 1, 2025
  
    We have completed our review of the October 2025 current procedural terminology (CPT) including any ...
  
    P        F  
    Jul 1, 2025
  
    We have completed our review of the July 2025 CPT code changes, including any category II performanc...
  
    P        F  
    Jul 1, 2025
  
    Immunizations Adult and Pediatric Policy Effective July 1, 2025, there are five new codes that ...