1 CareFirst on CallInstitutional Reference CardPCM1035 -1P (8/16)Commercial: 800-842-5975 | 202-479-6560 | NASCO Service and Out-of-Area Claims: 877-228-7268 FEP (Northern VA, DC, Montgomery and Prince George s Counties): 202-488-4900 FEP (all other MD FEP Providers): 410-581-3568 | 800-854-5256 Enter Provider NumbersFor Participating Institutional Providers For best results, use your 3-digit Regional Provider Number. Your Federal Tax ID or your Billing NPI can also be and Out-of-State Providers For best results, use your Tax ID. You can also use your Billing TypesIf the system does not recognize your provider number, it will ask you to select your provider type from the list below.
2 Hospital Non-Hospital Facility Dentist Routine Vision Provider Professional ProviderEnter Member Numbers Membership numbers are most easily entered using the telephone keypad. Do not enter the 3 letter prefix that is present on most BlueCross Blue Shield membership numbers. Do not enter the R that precedes Federal Employee Program membership OptionsGeneral information is available for: Eligibility Benefits Deductibles and Maximums Claims Status Authorization Status Frequently Requested InformationThe Fax Back FeatureTo get a fax of your information, follow the voice prompts.
3 You will receive one fax for each inquiry, for each BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are both independent licensees of the Blue Cross and Blue Shield Association. Registered trademark of the Blue Cross and Blue Shield Association. Registered trademark of CareFirst of Maryland, HintsKey Commands9 Back to the Main Menu0 Transfer to Customer ServiceEnter Alphabetic CharactersIf your provider number or the membership number has letters in it, you must press 3 keys for each letter.
4 #1 Press the star key to indicate you are about to enter a letter. #2 Press the key containing the letter. #3 Press the number that coincides with the position of the letter on that Cuts For yes and no prompts and questions: Say yes or press 1 Say no or press 2 Alphabetic Conversions:a = *21b = *22c = *23d = *31e = *32f = *33g = *41h = *42i = *43j = *51k = *52l = *53m = *61n = *62o = *63p = *71q = *72r = *73s = *74t = *81u = *82v = *83w = *91x = *92y = *93z = *94 Enter Dates Say the date you wish to enter. For instance: January First Two Thousand Fourteen, or using the key pad, you would enter 0 1 0 1 2 0 1 4 on your access this guide and other reference guides available, visit on call Institutional Reference CardProvider Benefit Codes for Institutionally Billed ServicesThese benefits are categorized by the following Services125 Allergy Testing186 Cat-Scan202 Colonoscopy252 EEG/Electroencephalogram and EKG/Electrocardiogram420 Laboratory Tests/Medical421 Laboratory Test/Routine423 Medical Diagnostic (Machine) Test/Routine425 Medical Diagnostic (Machine)
5 Test/Medical436 Mammogram- Routine456 MRI/Magnetic Resonance Imaging462 Neurological Testing488 Pap Smear/Routine502 Pre-Admission Testing/Laboratory504 Pre-admission testing/Radiology/X-Ray657 Sleep Studies676 Surgical Pathology684 TMJ/Temporomandibular Joint X-rays736 Ultrasound/Maternity738 Ultrasound/Non-Maternity750 Radiology/X-RayMaternity/Contraception/ Infertility Services110 Abortion Elective114 Abortion Therapeutic174 Artificial Insemination176 Birthing Centers222 Contraceptive Devices224 Contraceptive/Medically Necessary/Injection226 Contraceptive/Medically Necessary/ OP/Facility228 Contraceptive/Medically Necessary/Oral232 Contraceptive/Routine/Injection234 Contraceptive/Routine/OP/Facility236 Contraceptive/Routine/Oral352 Gamete and Zygote Transfers /Facility384 Home Maternity Visits111 Infertility Services428 Intrauterine Insemination432 In Vitro Fertilization/Facility448 Maternity Global464 Newborn Care618 Reverse Tubal Ligation624 Reverse Vasectomy630 Maternity Admission/Facility632 Maternity Admission with Complications/Facility736 Ultrasound/MaternityMedical122 Admission/Observation/OP131
6 Allergy Services178 Blood Derivatives 182 Blood /Whole/Plasma/Facility300 Emergency Room/Medical410 Immunizations/Medical424 Injections/Medications470 Clinic Visit Facility Fees473 Outpatient/Hospital Facility640 Medical/Surgical Admission/Facility675 Skilled Nursing Facility/FacilityMedical Emergency/Accidental Injury230 Dental Services/Accidental290 Emergency Room/Accident740 Urgent Care Center/Accident742 Urgent Care Center/Medical EmergencyMental Health/Substance Abuse 238 Substance Abuse Detoxification256 Electroshock Therapy452 Methadone Treatment475 Partial Hospitalization/Facility492 Pharmacology/Management/Mental Health510 Mental Health/Substance Abuse/Outpatient512 Mental Health Halfway House516 Mental Health Testing540 Substance Abuse Rehabilitation/Freestanding Facility550 Substance Abuse Rehabilitation650 Mental Health Admission/FacilityOther 118 Admission/Non-Med/Custodial160 Ancillary190 Chemotherapy240 Dialysis244 Diabetic Education/Training246 Diabetic Supplies370 Home Health Care374 Home Hemophilia Drugs376 Home Hemophilia Supplies400 Hospice402 Hospice/Bereavement Counseling404 Hospice/Family Counseling405
7 Hospice Respite Care406 Hyperbaric Oxygen Therapy412 Infant Medical Foods418 Infusion Therapy/Facility426 Insulin469 Nutritional Counseling496 Photochemotherapy509 Pulmonary Rehabilitation Program520 Radiation Therapy 530 Cardiac Rehabilitation614 Respiratory TherapySurgery/Anesthesia140 Ambulatory Surgery Facility170 Anesthesia454 Morbid Obesity/Gastric Bypass472 Oral Surgery670 Surgery 674 Surgical Assistance676 Surgical Pathology682 TMJ/Temporomandibular Joint Surgery686 Transplants, Medically Necessary, non-experimentalTherapy/Chiropractic/Acu puncture172 Aqua Therapy356 Occupational Therapy/Habilitative358 Physical Therapy/Habilitative362 Speech Therapy/Habilitative460 Occupational Therapy/Rehabilitative500 Physical Therapy/Rehabilitative660 Speech Therapy/Rehabilitative Vision/Hearing/Dental231 Dental Services/Medical 360 Hearing Test364 Hearing Aid368 Hearing Exam/RoutineMedical Equipment.
8 Prosthetics and Supplies184 Breast Prosthesis246 Diabetic Supplies250 Durable Medical Equipment/Purchase or Rental376 Home Hemophilia Supplies440 Medical Supplies474 Orthopedic Appliance/Purchase476 Orthopedic Appliance/Rental484 Orthotics486 Oxygen/Oxygen Equipment508 Prosthetics744 Wigs/Hair Prosthesis