CommercialAdministrativeHigh impact
AB2026-02-001 Updates and new information
Capital Blue Cross·PA · Radiology, Cardiology, Oncology·Provider News
Effective date
Feb 23, 2026
We identified it
Jun 20, 2026
Summary
Capital Blue Cross is implementing major changes to appeals processes, requiring electronic submission through Availity Essentials starting February 23, 2026, with mail/fax submissions ending April 1, 2026. Additionally, anatomical modifiers will be required for radiology procedures starting April 1, 2026, and several medical policy updates take effect March 1, 2026.
Action Required
By February 23, 2026: Set up electronic appeals submission through Availity Essentials provider portal. Complete training via Help and Training > Get Trained > Search 'Appeals'. By April 1, 2026: Stop all mail/fax appeals submissions and ensure anatomical modifiers (RT, LT, FA, F1-F9, TA, T1-T9) are included on all radiology procedure claims. Update billing software to require anatomical modifiers for radiology codes. Claims without proper modifiers or appeals via mail/fax will be denied after April 1, 2026.