CommercialAdministrativeHigh impact
AB2026-04-001 Updates and new information
Capital Blue Cross·Provider News
Effective date
May 1, 2026
We identified it
Jun 20, 2026
Summary
Capital Blue Cross is implementing major changes including mandatory electronic appeals submission through Availity Essentials (May 1), required CAS codes on COB claims (June 1), and mandatory 11-digit NDCs for all drug claims (June 1). Multi-factor authentication is now required for the Prime MPS GatewayPA portal.
Action Required
By May 1, 2026: Billing team must transition all appeals to Availity Essentials portal - mail/fax appeals will no longer be accepted. Complete training through Help and Training menu. By June 1, 2026: Update billing system to include CAS codes on all COB claims or they will reject with code S4005A. Also ensure all drug claims include valid 11-digit NDCs with correct unit measures and quantities. Immediately: Enable multi-factor authentication for Prime MPS GatewayPA portal users.