CommercialBilling CodesHigh impact
Payment Policy Updates
CareFirst BlueCross BlueShield·Anesthesiology·Reimbursement
Effective date
Nov 1, 2026
We identified it
Aug 26, 2026
Summary
CareFirst has updated Home Health - Facility billing codes (PP CO 900.01) effective November 1, 2026, and clarified mandatory modifier requirements for CRNA anesthesia billing to prevent denials. Additionally, two payment system issues (EFT payments issued as checks and ERA reporting discrepancies) remain under investigation with no provider action needed at this time.
Action Required
By October 15, 2026: Billing team must obtain the updated Companion Table codes from CareFirst's Payment Policy Reference Manual (PP CO 900.01) and reprogram billing software to reflect new Home Health - Facility code requirements. Immediately: All providers billing anesthesia services must ensure CRNA claims include mandatory modifiers QX or QZ; claims submitted without these modifiers will be denied. Billing team must audit recent anesthesia claims submitted by credentialed CRNAs to identify and correct any claims billed under non-rostered groups with incorrect or missing modifiers. Update billing system validation rules to require QX or QZ modifiers for all CRNA professional claims. Reference Payment Policy PP CO 013.01 for complete modifier definitions (AA, QK, QY, AD, QX, QZ). Communicate with all providers billing anesthesia services regarding these modifier requirements to prevent future denials.