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Sep 1, 2020

Methadone reimbursement guidelines for BCBSRI commercial members with Medicare as primary coverage

If a provider renders methadone maintenance services to a BCBSRI commercial member who has federal Medicare as their primary insurance coverage, the provider must bill the member’s Medicare coverage for services rendered, as this is now a Medicare benefit. Any claims received for a commercial member with federal Medicare as their primary coverage will be denied and sent back to the provider with the explanation “File to Medicare first.”