CommercialCoverageMedium impact
Philips Recall: CareFirst Implements Replacement Process
CareFirst BlueCross BlueShield·Sleep Medicine, Pulmonology·Provider News
Effective date
Jun 14, 2021
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is implementing a streamlined replacement process for recalled Philips BiLevel PAP, CPAP, and mechanical ventilators, treating them as non-functioning before the typical 5-year replacement period. The policy waives sleep study requirements for replacements and allows reimbursement for out-of-pocket purchases, with specific claim submission requirements including recalled device model numbers and RA modifiers.
Action Required
Immediately: Billing team must update claim submission procedures for Philips device replacements to include recalled device model number in notes section, use RA modifier indicating reason for replacement, attach physician prescription/medical order, and include documentation proving device is on recall list. Train staff on two-process system for provider replacements versus member reimbursements.