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CareFirst Implements Changes to Observation Admission
CareFirst BlueCross BlueShield·Emergency Medicine·Provider News
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
CareFirst is implementing new notification requirements for observation admissions effective January 1, 2023, requiring in-network facilities to notify within 7 days when observation services start. Additionally, observation services will be limited to 72 hours, after which patients must be admitted to inpatient status or discharged.
Action Required
By January 1, 2023: Hospital billing teams must implement notification process for all observation admissions within 7 calendar days of observation services starting. Update workflow to monitor 72-hour observation limit and coordinate with clinical staff for timely admission or discharge decisions. BlueChoice patients require switching from outpatient observation requests to admission notifications in the authorization system.