CommercialAdministrativeHigh impact
Effective August 1, 2024: Updated Requirements for All Inpatient and Observation Admissions
CareFirst BlueCross BlueShield·Reimbursement
Effective date
Aug 1, 2024
We identified it
Jun 20, 2026
Summary
Effective August 1, 2024, CareFirst requires 24-hour notification for all inpatient admissions and observation stays, submitted as inpatient requests with level of care indicated using revenue codes. This replaces previous notification requirements and affects all CareFirst members across all plan types.
Action Required
By August 1, 2024: Hospital billing teams must update workflows to submit 24-hour notifications for ALL inpatient admissions and observation stays as inpatient requests (not outpatient requests). Include appropriate revenue codes to indicate level of care on all inpatient requests. For CareFirst Community Partners Medicaid members, notify within 48 hours or next business day for weekends/holidays. Failure to provide timely notification may result in claim denials.