CMS released a new code J0175 effective July 2nd, 2024. These updates will be added to our claims processing system and are effective July 2nd, 2024.  

Please submit your comments and concerns regarding coverage and payment designations to: 

Blue Cross & Blue Shield of Rhode Island 

Attention: Medical Policy, HCPCS review 

500 Exchange Street 

Providence, Rhode Island 02903 

Please note that as a participating provider, it is your responsibility to notify members about non-covered services prior to rendering them. 

Revised July 2024 HCPCS Updates: 

Please note: Coverage and/or payment rules for code(s) below may be subject to change for Medicare Advantage Plans and/or Commercial Products. 

Commercial Products:

New HCPCS Code J0175 will be not covered for Institutional and Professional providers for Commercial Products effective for dates 7/2/2024 through 9/30/2024. 

Effective starting on 10/1/2024, J0175 will be subject to medical review for both Professional and Institutional providers (Pharmacy Benefit) for Commercial Products. 

Medicare Advantage Plans: 

New HCPCS Code J0175 will be covered and separately reimbursed for Institutional and Professional providers for Medicare Advantage Plans, effective for dates 7/2/2024 through 7/31/2024. 

Effective starting on 8/1/2024, HCPCS Code J0175 will be subject to medical review for Professional and Institutional providers (Pharmacy Benefit) for Medicare Advantage Plans.