Effective October 1, 2026, BCBSRI will implement a correct coding edit within our claims processing system. This edit is based on requirements from the Centers for Medicare & Medicaid Services (CMS) related to therapy services. 

Claims submitted with therapy service revenue codes 042X, 043X, or 044X must include the appropriate therapy service modifier appended to the CPT code. Specifically, providers should append modifier GP for physical therapy, GO for occupational therapy, or GN for speech-language pathology services, as applicable. 

Claims submitted with one of these revenue codes and a modifier is missing, or the wrong required therapy modifier is appended for dates of service on or after October 1, 2026 will be denied.

If you have any questions regarding this update, please contact ProviderRelations@bcbsri.org.