Per EOHHS, effective immediately,  providers can directly bill Medicaid fee for service for SUD residential when the recipient has a Blue RI for Duals Medicare Advantage Plan.  A denial from the Medicare Advantage Plan is no longer required by Medicaid for the following codes:  

• H0001 UD – Alcohol and /or drug assessment 60-90 minutes
• H0004 UD – Individual counseling and therapy, per 15 minutes
• H0005 UD – Group counseling and therapy 

BCBSRI would like to thank our Residential Treatment Provider partners for their willingness to service these vulnerable Rhode Islanders in need of care.  If you have any questions about this change, please reach out to BCBSRI’s behavioral health team at behavioralhealth@bcbsri.org.