CommercialPrior AuthMedium impact
New Durable Medical Equipment Codes Added to Prior Authorization Requirement
CareFirst BlueCross BlueShield·PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy +2 more·Prior Authorization
Effective date
Aug 1, 2023
We identified it
Jun 20, 2026
Summary
Starting August 1, 2023, CareFirst will require prior authorization for power operated vehicles, power wheelchairs, and power mobility devices for BlueChoice HMO and CareFirst PPO members. This adds new DME codes to their existing prior authorization requirements.
Action Required
By August 1, 2023: Billing team must update system to require prior authorization for all power operated vehicles, power wheelchairs, and power mobility device DME codes for CareFirst BlueChoice HMO and CareFirst PPO members. Check CareFirst's DME Prior Authorization List on their website for specific codes. Claims will be denied without prior authorization.